| NPI | 1063261519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI BAKER Licensing COO Rdinator 564-203-3620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311500000X Alzheimer Center (Dementia Center) |
| Enumeration Date | 2024-05-16 |
| Last Update Date | 2024-05-16 |