| NPI | 1548036759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRASHONDA RENA DEWALT Program Manager 832-579-4545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-11-29 |
| Last Update Date | 2026-06-12 |