| NPI | 1831229483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN BRUCE JOHNSON Adult Foster Care Provider 806-886-5244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: TX 001012032) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2020-08-22 |