| NPI | 1962805838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATOSHA ANTIONETTE JONES Owner 972-510-3133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2014-10-06 |
| Last Update Date | 2014-10-06 |