| NPI | 1053239533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY SLOANE CARLSON Owner/Operator 512-290-2216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2026-07-09 |
| Last Update Date | 2026-10-04 |