| NPI | 1700105426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAAGHE MMBI FOGWE Owner/Manager 817-715-0236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2010-05-20 |