| NPI | 1265993133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY PAIGE MORRISON Director Of Clinical Compliance 512-278-4944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2022-05-23 |