| NPI | 1245657642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNSEY JACKSON Managing Member 832-434-3035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 34929) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: TX 34929) |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2014-03-24 |