| NPI | 1750742995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISHA ANN EVANS-DAVIS Program Administrator 817-875-2535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2016-03-16 |