| NPI | 1245841758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNTAY M MCCLURE Program Manager 832-216-2893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2020-08-10 |