| NPI | 1043911597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN JEFFERSON Director 469-584-0824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 172V00000X Community Health Worker | |
| 251E00000X Home Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2023-03-13 |
| Last Update Date | 2025-02-28 |