| NPI | 1720454929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RETA VELISSA SANDERS Pragram Manger 903-917-2458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2015-08-11 |