| NPI | 1366003691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATISHA LA'TREAS COLEMAN Program Manager 832-906-5975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 251S00000X | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2019-06-26 |