| NPI | 1376906651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANETTE WADE Owner/Director 817-706-5360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2016-04-03 |
| Last Update Date | 2016-04-03 |