| NPI | 1720223274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI D. WILSON Program Directoer 512-385-4799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 1920-1920 A) |
| Enumeration Date | 2008-12-12 |
| Last Update Date | 2010-01-05 |