| NPI | 1336813138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIS FEROW MIMS Administrator 936-529-4745 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2021-08-04 |