| NPI | 1144932351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL TENNYSON TOLL Executive Director 817-888-6974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-12-19 |
| Last Update Date | 2022-12-22 |