| NPI | 1700191996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOLA ONI Administrator 817-800-9948 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: TX 114288) |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2010-08-11 |