NPI | 1417505124 |
---|---|
Entity Type | Organization |
Authorized Contact | JEFFREY ENGELKE President 512-916-1632 |
Organization Subpart ? | Yes |
Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded |
Enumeration Date | 2019-08-27 |
Last Update Date | 2019-08-27 |