| NPI | 1275159527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | POLLY CLARK Billing Services Manager 512-649-4409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2020-06-23 |