| NPI | 1336731454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHENGETAI BEVERLY JAMES Phc Coordinator 214-659-1138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant |
| Enumeration Date | 2021-02-10 |
| Last Update Date | 2023-11-15 |