| NPI | 1417623232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALLIE DENISE MITCHELL Owner 817-849-4005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2021-08-20 |
| Last Update Date | 2023-03-29 |