| NPI | 1356557425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCI M SILVA Financial Services Administrator 915-782-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251S00000X (Licence: TX 402) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 261QM2800X Clinic/Center, Methadone Clinic | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2019-12-18 |