| NPI | 1083180095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER PENROD Authorized Rep 832-289-9225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2018-10-17 |
| Last Update Date | 2018-10-17 |