| NPI | 1134951940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS LOUALLEN CEO/ Rc 667-392-6162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-08-19 |
| Last Update Date | 2024-08-19 |