| NPI | 1356901607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK M TOVAR Owner 210-588-0863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2019-06-18 |