| NPI | 1417795642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN CLACK CEO 214-435-6716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103K00000X Behavior Analyst | |
| 103TC0700X Psychologist, Clinical | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2024-07-20 |
| Last Update Date | 2024-07-20 |