| NPI | 1235658402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKEISHA DONYELE GATLING Owner 832-791-2076 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 58846) |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2017-09-19 |