| NPI | 1306082243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE JOHNSON Program Manager 832-330-0756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2008-12-24 |
| Last Update Date | 2008-12-24 |