| NPI | 1083816086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM R DEREMER Director 512-257-0066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: TX 1947A) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2020-08-22 |