| NPI | 1629539101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INDA GREEN Owner 210-527-9644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251B00000X Case Management |
| 251J00000X Nursing Care | |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2019-03-27 |