| NPI | 1003191750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA STEPHNEY COO 469-778-0017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2022-02-08 |