| NPI | 1407005929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVORY LEE PETE Owner 281-706-3717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: TX 101623) |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2008-09-09 |