| NPI | 1942365606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IFY OBI Coordinator 832-298-0089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2006-12-23 |
| Last Update Date | 2024-08-06 |