| NPI | 1861718140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRY DENISE CROW Owner 817-896-4587 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2010-04-12 |