| NPI | 1235175704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI D. WILSON Program Director 512-385-4799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 1920-A) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2020-08-22 |