| NPI | 1154186484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA R WILLMON Owner 512-333-4040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-02-15 |
| Last Update Date | 2024-09-06 |