| NPI | 1427738913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEN AHARANWA Owner 817-822-6404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility Nursing Care, Pediatric |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility Adult Care Home |
| 335G00000X Medical Foods Supplier | |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| 385HR2065X Respite Care Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2023-07-20 |
| Last Update Date | 2023-08-30 |