| NPI | 1639554686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL RYAN ROBICHEAUX Owner 214-640-0080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2015-07-20 |