| NPI | 1215706973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABIODUN ADELOWO Member 817-677-0750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-12-21 |
| Last Update Date | 2023-12-21 |