| NPI | 1720649049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE FREABE Owner 210-330-9905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2019-09-05 |