| NPI | 1265058143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA M COOK CEO 469-508-4516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2020-06-17 |
| Last Update Date | 2020-06-17 |