| NPI | 1023779733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI EDWARDS VP Of Revenue Strategy 817-966-2764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-01-05 |
| Last Update Date | 2022-01-05 |