| NPI | 1295061174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIZA AVA FOSTER President 281-250-7207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2009-10-27 |
| Last Update Date | 2019-07-17 |