| NPI | 1245656503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE LEATH Counselor 817-999-6410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 67708) |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2014-03-11 |