| NPI | 1013254754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH MATTHEW GARDZINA Director 979-480-3327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 261QM1300X Clinic/Center, Multi-Specialty (Licence: TX 3592) | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: TX 3592) | |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2013-01-15 |