| NPI | 1134990666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA POWELL Owner 972-765-8710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-01-12 |
| Last Update Date | 2024-01-12 |