| NPI | 1861117210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NTEESHA SHERLENE SMITH Program Manager 469-449-7858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 251T00000X PACE Provider Organization | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 251J00000X Nursing Care | |
| 251K00000X Public Health or Welfare | |
| 313M00000X Nursing Facility/Intermediate Care Facility | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 253Z00000X In Home Supportive Care | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 251B00000X Case Management | |
| Enumeration Date | 2022-10-07 |
| Last Update Date | 2026-06-26 |