| NPI | 1043537343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND R CARVAJAL Program Sponsor 210-924-7547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: TX 33) |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2010-04-26 |