| NPI | 1710148929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA RENE SMITH Owner 817-204-8462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 311ZA0620X Custodial Care Facility Adult Care Home | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2008-07-31 |