| NPI | 1851796841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEINATI POTOAE Manager/Administrator 254-245-1423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: TX 802085447) |
| Enumeration Date | 2014-11-03 |
| Last Update Date | 2014-11-03 |