| NPI | 1003628496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TURISTA JACKSON President 832-744-0385 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2025-01-22 |
| Last Update Date | 2025-02-03 |