| NPI | 1154085611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS H GAULTNEY Manager 210-985-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-10-29 |
| Last Update Date | 2023-04-10 |