| NPI | 1528320520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NOLAN FREEMAN Manager 972-310-8741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: TX 128061) |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2018-11-05 |