| NPI | 1295616597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULITO UY Owner 806-418-2170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2025-09-11 |
| Last Update Date | 2025-09-20 |