| NPI | 1720744808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSUELA DOLEZAL Administrator 580-725-3533 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded |
| Enumeration Date | 2021-11-12 |
| Last Update Date | 2021-11-12 |