| NPI | 1699523829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDREY ELAINE DAVIS Administrator 214-551-6470 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2024-05-13 |
| Last Update Date | 2024-05-13 |