| NPI | 1972373017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAMONICA JARJU CEO, Administrator 903-330-9625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-01-08 |
| Last Update Date | 2024-01-08 |