| NPI | 1477839082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY KUTRACE MOORE President 817-500-8496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: TX SSN/ITIN/EIN) |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2011-10-26 |