| NPI | 1780639245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE LEIGH CALVERT Adminstrator 210-520-0774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: TX 116568) |
| Additional Taxonomies | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: TX 115509) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2007-07-11 |