| NPI | 1295803252 |
|---|---|
| Other Name | CRATER LAKE HOME |
| Entity Type | Organization |
| Authorized Contact | SYLVIA ARRIOLA President/Administrator 210-661-6262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: TX 114060) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2021-09-10 |