| NPI | 1598901522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRINE L PATRICK Owner 817-615-8602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2008-12-22 |
| Last Update Date | 2008-12-22 |