| NPI | 1700763125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALINDA DANIELS Program Manager 210-578-1509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-08-18 |
| Last Update Date | 2025-08-18 |