NPI | 1144666264 |
---|---|
Entity Type | Organization |
Authorized Contact | JEMECE MICHELLE GASAWAY Director Of Licensing 214-365-6126 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MO 1305-3) |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
261QM2800X Clinic/Center, Methadone Clinic (Licence: MO 1305-3) | |
Enumeration Date | 2013-05-15 |
Last Update Date | 2019-02-21 |