| NPI | 1255644068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOREN M RIOUX Sole Member 214-843-4525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 201256) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: TX 64853) |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2010-07-21 |