| NPI | 1184920472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH MATTHEW GARDZINA CEO 979-480-3327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: TX 7657) |
| Enumeration Date | 2011-02-03 |
| Last Update Date | 2017-10-17 |