| NPI | 1801124342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHALILAH DOUGLAS Director 210-396-8472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2009-11-20 |
| Last Update Date | 2009-11-20 |