| NPI | 1053738955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHYRA NICHELLE JONES Owner 254-681-6702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 66025) |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2017-04-07 |