| NPI | 1063614022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DON LILLJEDAHL Director Of Founation 512-443-5777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 115787) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: TX 115796) |
| 251S00000X Community/Behavioral Health (Licence: TX 114956) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2020-08-22 |