| NPI | 1801056379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLATUNJI OLALEYE USMAN Manager 817-344-9159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2008-06-09 |