| NPI | 1306549803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KONETTE D HORTON President 469-733-3261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2023-03-23 |
| Last Update Date | 2023-03-23 |