| NPI | 1356897797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEOFFREY BRUNO Owner 210-563-0768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2016-08-26 |