| NPI | 1164863312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCI M BRUNO Billing Specialist 903-957-4861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: TX 3703-3704) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: TX 3703-3704) |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2016-03-23 |