| NPI | 1235666959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY CROWDER KING Owner 469-247-8349 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: TX 57617) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: TX 57617) |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2017-05-12 |