| NPI | 1134597768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKY VELOSO Receptionist 210-366-3700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 70305) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 16640) |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2015-09-14 |