| NPI | 1992980601 |
|---|---|
| Doing Business As | NONE |
| Entity Type | Organization |
| Authorized Contact | BENNIE E SCOTT Program Manager 512-496-6623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2008-01-02 |