| NPI | 1457583072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHESHIEKA HEARD Program Director 430-625-7410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2009-08-15 |
| Last Update Date | 2022-12-15 |