| NPI | 1770092876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEKEYA LEE Owner 936-545-6074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251S00000X | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2017-09-21 |
| Last Update Date | 2022-07-21 |