| NPI | 1639639982 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | KRYSTLE BICKNELL WOMACK Owner/Program Manager 903-521-1429  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 251B00000X Case Management | 
| Additional Taxonomies | 171W00000X Contractor | 
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251S00000X Community/Behavioral Health | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2019-03-22 | 
| Last Update Date | 2022-07-27 |