| NPI | 1184008500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JALAYNE GOSS Reimbursement Manager 640-552-4055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 283Q00000X Psychiatric Hospital (Licence: TX AP126371) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2015-07-15 |