| NPI | 1790017119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DON N EZENNIA C.E.O 972-429-6644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X | |
| 253Z00000X In Home Supportive Care | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 385H00000X Respite Care | |
| Enumeration Date | 2010-02-10 |
| Last Update Date | 2010-04-27 |