| 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 | 2019-07-03 |