| NPI | 1275195596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER BLASINGAME Manager 214-282-0258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2019-07-08 |