| NPI | 1649570706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH N UKAH Manager 832-877-3806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2010-10-23 |
| Last Update Date | 2010-10-26 |