| NPI | 1760109433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMAH AWOZELE Program Manager 832-904-0998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-10-24 |
| Last Update Date | 2023-04-25 |