| NPI | 1629138144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERENCE J FISHER Director 281-528-0769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2022-01-19 |