| NPI | 1639843279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELYNE DUSABE Administrator 469-648-8397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2021-08-06 |
| Last Update Date | 2021-08-06 |