| NPI | 1336288489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH P KRUCIAK Executive Director 210-599-1938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: TX 911) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-08-22 |