| NPI | 1760728885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANDRA DENISE WILSON Owner 214-710-0156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: TX 135796) |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2012-12-18 |