| NPI | 1265981070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLATUBOSUN TUSIN RAYMOND Owner 214-334-4411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2016-09-22 |