| NPI | 1376899427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT ANTHONY PINE Member Manager 469-964-5687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 64634) |
| Enumeration Date | 2012-07-26 |
| Last Update Date | 2012-07-26 |