| NPI | 1528411303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILYN DICKERSON Owner/ Manager 281-846-8183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2019-04-19 |