| NPI | 1407134448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY CAROLE FULLER Program Director 806-773-6575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: TX 671297) |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2011-07-25 |