| NPI | 1053059204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA DURHAM Owner 469-635-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-05-26 |
| Last Update Date | 2025-07-21 |