| NPI | 1588805162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN LAVERN MANTLE Owner 281-351-0124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: TX 12363955) |
| Additional Taxonomies | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: TX 12363955) |
| Enumeration Date | 2009-03-12 |
| Last Update Date | 2009-03-12 |