| NPI | 1437534559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDI TURNER Licensing Coordinator 682-707-2756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2025-05-13 |