| NPI | 1487575726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY POLK CFO 903-999-1983 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 171W00000X Contractor |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 261Q00000X Clinic/Center | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 310400000X Assisted Living Facility | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 385H00000X Respite Care | |
| Enumeration Date | 2026-07-23 |
| Last Update Date | 2026-07-23 |