| NPI | 1013372374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER MICHELLE BARTON Lcdc 432-570-3390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 13198) |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2015-12-30 |