| NPI | 1134385305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA J HENRY Proprietor 469-328-8810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 26057) |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2008-08-06 |