| NPI | 1790180024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATRECE JOHNSON Owner 281-995-7917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2023-08-28 |