| NPI | 1346887411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HALLIE SHEADE Executive Director 682-703-0794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-12-07 |
| Last Update Date | 2022-01-13 |