| NPI | 1265975163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA J PETERSEN Provider/Owner 214-213-4726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: TX AP115470) |
| Enumeration Date | 2016-11-23 |
| Last Update Date | 2017-08-24 |