| NPI | 1093938144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNIE C. LA QUAY Owner 361-578-2800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 18848) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-08-22 |