| NPI | 1003689936 |
|---|---|
| Doing Business As | THE FULLBROOK CENTER |
| Entity Type | Organization |
| Authorized Contact | JOSE A MIRANDA Director Of Ur 210-485-8065 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2023-11-02 |
| Last Update Date | 2024-05-08 |