| NPI | 1073175576 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | DAVID B GROWCOCK Owner 210-439-9567 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health | 
| Enumeration Date | 2019-07-03 | 
| Last Update Date | 2025-09-11 |