| NPI | 1396163283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH LUCOMBE Program Manager 214-516-5037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2014-03-29 |
| Last Update Date | 2014-03-29 |