| NPI | 1558042234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL BOYLE Director Cred 512-765-9003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2023-07-26 |
| Last Update Date | 2024-05-13 |