| NPI | 1437446507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IMAN J ROSS President/Founder 469-236-3999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TX 18030) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 99184) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 6742) | |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2011-07-08 |