| NPI | 1255633152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KASHONDA JUANITA BRADFORD Lvn 832-581-8556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2010-11-28 |
| Last Update Date | 2013-07-19 |