| NPI | 1811368491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA MARIE BROOKE Therapist 469-360-3177 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MA 220932) |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2015-10-08 |