| NPI | 1750733234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENYATTA JACKSON Owner 832-630-7382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2016-07-07 |