| NPI | 1629808274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMEKA KOTUN Owner 832-986-2826 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 343800000X Secured Medical Transport (VAN) |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2024-08-07 |
| Last Update Date | 2024-08-14 |