| NPI | 1922482751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINITA SPANN Manger 903-597-1351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251B00000X Case Management |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2025-10-09 |