| NPI | 1356562680 |
|---|---|
| Doing Business As | RESIDENTIAL TREATMENT CENTER CLINIC |
| Entity Type | Organization |
| Authorized Contact | CHUCK WALZEL CFO 210-334-3724 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: TX HBOCS00758-04-00) |
| Additional Taxonomies | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: TX HBOCS00-04-00) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2010-01-26 |