| NPI | 1700288867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEIZO D ADKISON Executive Director 469-396-9117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2014-09-19 |