| NPI | 1902346414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDI TURNER Licensing Coordinator 682-707-2756 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2025-05-12 |