| NPI | 1760998934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLET F ORIAKHI Program Manager 512-400-5137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2017-12-22 |
| Last Update Date | 2018-06-22 |