| NPI | 1033303375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENDA JEAN FAULKNER Owner/Director 214-923-8712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 15239) |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2013-04-02 |