| NPI | 1568661353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCAS TAMBE Administrator 512-453-1488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2007-07-12 |