| NPI | 1306578224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY L BRUDNICKI Owner 936-395-1051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 251S00000X | |
| Enumeration Date | 2022-06-29 |
| Last Update Date | 2022-08-19 |