| NPI | 1659608453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JOHNSON Owner 832-365-6752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2009-11-16 |
| Last Update Date | 2009-11-16 |