| NPI | 1407549231 |
|---|---|
| Former Legal Business Name | SELF |
| Entity Type | Organization |
| Authorized Contact | MACELINE EKU CHECK Provider 281-475-0073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-05-29 |
| Last Update Date | 2023-05-29 |