| NPI | 1114323466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARINA NELL Doctor 210-510-2868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: TX Q1868) |
| Enumeration Date | 2014-11-14 |
| Last Update Date | 2014-11-17 |