| NPI | 1629440961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABRAHAM MEDIA Managing 915-849-8978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 302F00000X Exclusive Provider Organization | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 315D00000X Hospice, Inpatient | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2015-10-26 |