| NPI | 1669364949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRYSTAL POTTER Owner 210-912-3738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-07-19 |
| Last Update Date | 2025-07-19 |