| NPI | 1144006503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON TODD BAKER Owner/CEO 817-812-2880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2023-09-01 |
| Last Update Date | 2023-09-01 |