| NPI | 1386204683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISEL RODRIGUEZ Director 939-257-3471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children | |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2019-06-18 |