| NPI | 1063943041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON MALISH CEO 830-708-0767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 283Q00000X Psychiatric Hospital | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2023-03-07 |