| NPI | 1366998718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL BOETHEL Principal 214-535-6071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: TN ACL0000000376) |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2016-08-26 |