| NPI | 1245616531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS THOMAS LORENC Owner 972-313-5742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 62073) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2015-08-10 |