| NPI | 1720704513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER ELLIS COOKS Owner 903-521-8835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2022-10-13 |
| Last Update Date | 2022-10-13 |