| NPI | 1174202600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASMINE RANDOLPH Consultant/Manager 832-730-9817 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0208X Clinic/Center, Radiology, Mobile |
| Additional Taxonomies | 251B00000X Case Management |
| 261QG0250X | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2023-07-12 |
| Last Update Date | 2023-08-30 |