| NPI | 1083297121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY WYLLYS Sole Member/ Social Worker 512-227-4251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2021-05-05 |
| Last Update Date | 2021-05-05 |