| NPI | 1124501937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE PENDLETON Owner 214-618-2476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2018-09-09 |
| Last Update Date | 2019-08-27 |