| NPI | 1053850065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH BUCKLE President 832-532-0129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-02-23 |
| Last Update Date | 2017-02-23 |