| NPI | 1346402070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODOLFO BASURTO President 915-779-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: TX 3550-3555) |
| Additional Taxonomies | 276400000X Rehabilitation, Substance Use Disorder Unit (Licence: TX 3550-3555) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2012-09-19 |