| NPI | 1639981558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE ANDERSON Owner 469-258-9214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-01-27 |
| Last Update Date | 2025-02-27 |