| NPI | 1326424441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID BAKER Comptroller 936-633-5668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: TX 3803-3804) |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2015-07-31 |