| NPI | 1275917965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD BENJAMIN Owner 214-791-2863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 251S00000X |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2018-12-20 |