| NPI | 1790163228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTIONETTE FELICIA FOSTER Owner 817-492-5948 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2015-05-17 |
| Last Update Date | 2015-05-17 |