| NPI | 1316346893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISAAC TUBONEMI Program Manager 512-785-7795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2014-08-20 |
| Last Update Date | 2014-08-20 |