| NPI | 1386206605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUNTER HANSEN Receptionist 210-202-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2021-06-25 |