| NPI | 1255137519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON C MCCOY Owner 254-727-8735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2025-02-19 |
| Last Update Date | 2025-02-19 |