| NPI | 1508591561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIDIER TWAGIRAYEZU Administrator 817-480-3474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-07-22 |
| Last Update Date | 2022-07-22 |