| NPI | 1073031183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY BANKS Member 832-562-8255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2020-05-26 |