| NPI | 1831442284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA J. CLEGG Program Manager 361-688-4734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: TX 2500000) |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2012-10-23 |