| NPI | 1003462623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUDDUS FUJITA MAUS Owner 512-644-8598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2019-08-11 |
| Last Update Date | 2019-08-11 |