| NPI | 1386042208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED BALLARD General Manager 512-423-0178 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 171W00000X Contractor | |
| 310400000X Assisted Living Facility | |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2014-12-09 |
| Last Update Date | 2022-05-03 |