| NPI | 1518914902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CLARK A R Supervisor 936-891-5572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: TX 0162112801) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2020-08-22 |