| NPI | 1013715077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TALAYA GREEN Mgr Member 469-584-0824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) | |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2025-03-05 |
| Last Update Date | 2025-04-02 |