| NPI | 1235473737 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | LORI REED Program Coordinator 817-584-5399 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | 
| Enumeration Date | 2012-11-21 | 
| Last Update Date | 2012-11-21 |