| NPI | 1043618333 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE PALACIOS Owner 817-821-3690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 64640) |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2014-12-18 |