| NPI | 1790112910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATESA SEWONA MITCHELL Owner 832-267-9829 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2013-10-02 |