| NPI | 1982919759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER SAMPLE Executive Director 210-696-2410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2010-08-17 |
| Last Update Date | 2010-08-17 |