| NPI | 1740638394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY TAYLOR CEO/ Program Manager 832-893-4200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2016-05-24 |