| NPI | 1285360560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KASI HOWARD Owner 210-838-0090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2022-07-28 |
| Last Update Date | 2022-07-28 |