| NPI | 1720371412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTINA L BROWN-SIMS CEO 469-774-1070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2011-05-27 |
| Last Update Date | 2011-05-27 |