| NPI | 1609389915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA JO FOX Program Manager/Owner 806-570-1719 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2017-11-08 |