NPI | 1427468016 |
---|---|
Entity Type | Organization |
Authorized Contact | ERICA ESQUEDA RIVERA Provider/Owner 915-202-5778 |
Organization Subpart ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 68797) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 12025) |
Enumeration Date | 2014-05-05 |
Last Update Date | 2020-10-21 |