| NPI | 1386977908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIESHA MAZIN EASTERLING Program Manager 469-865-9209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2009-09-14 |