| NPI | 1164711768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY BELLMY Exective Director 817-548-9990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: TX 2340B) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2011-04-05 |