| NPI | 1184490641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JADA ALEXANDER President 469-401-8195 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 251S00000X Community/Behavioral Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2023-11-27 |
| Last Update Date | 2024-01-22 |