| NPI | 1477329860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REDEATE LAKEW President 972-904-0057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 311500000X Alzheimer Center (Dementia Center) | |
| 311Z00000X Custodial Care Facility | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2023-11-28 |
| Last Update Date | 2023-11-28 |