| NPI | 1275142739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOPHIA CANNON Directr Of Clinical Services 469-986-9629 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2020-07-30 |
| Last Update Date | 2020-07-30 |