| NPI | 1700343902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA ANTOINETTE JONES Program Manager 936-714-3927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0630X Assisted Living Facility Assisted Living, Behavioral Disturbances |
| Enumeration Date | 2019-02-23 |
| Last Update Date | 2019-02-23 |