| NPI | 1063289023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATOYA OGIDAN Clinical D Irector 972-365-0346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-12-08 |
| Last Update Date | 2024-01-15 |