| NPI | 1205428794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY PEREZ WATERMAN Owner 210-827-3738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-02-07 |
| Last Update Date | 2021-02-07 |