| NPI | 1043468010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES DEREK SLOVER Lpc/Owner 254-855-7699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 62399) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2008-09-03 |