| NPI | 1255874699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD K MALLET Program Manager 281-248-6703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2016-12-01 |
| Last Update Date | 2017-01-18 |