| NPI | 1043070964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IAN COLE WATTS Owner / COO 806-438-8089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-03-19 |
| Last Update Date | 2024-03-19 |