| NPI | 1942463278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY A EWEKA Program Director 512-767-4128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2009-01-15 |