| NPI | 1861117210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NTEESHA SHERLENE SMITH Program Manager 469-445-7333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 310400000X Assisted Living Facility | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| Enumeration Date | 2022-10-07 |
| Last Update Date | 2025-05-28 |