| NPI | 1992685390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BASIMAH DHAKIRAH ABUBAKAR Registered Nurse/Manager 682-717-9077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-09-05 |
| Last Update Date | 2025-09-05 |