| NPI | 1285133074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDREY PATTON Contracted Credentialer 832-889-6304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2018-02-07 |