| NPI | 1710692736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA DENNIS Owner 469-254-1298 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness |
| 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2023-01-16 |
| Last Update Date | 2023-01-16 |