| NPI | 1346890860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONISWA PORTIA MADUNA Owner 832-805-0933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2019-09-17 |