| NPI | 1740756774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE CLUBB Secretary 210-617-3255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385H00000X Respite Care |
| Additional Taxonomies | 177F00000X Lodging |
| 251S00000X | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2018-10-17 |
| Last Update Date | 2018-10-17 |