| NPI | 1336789007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMMIE DEMOND BURRELL Program Manager 832-316-1182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-01-10 |
| Last Update Date | 2020-01-10 |