| NPI | 1194849752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP ROOS Director 817-461-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2020-08-22 |