| NPI | 1417836636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLUGBUYI DARE FASHOYIN Doctor 325-899-2588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 276400000X Rehabilitation, Substance Use Disorder Unit | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2025-09-01 |
| Last Update Date | 2025-09-01 |