| NPI | 1902043276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIS BENJAMIN Progran Manager 817-534-5480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2009-01-08 |