| NPI | 1447462197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARIAN SHANE WEST Owner 210-403-9372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: TX 84V) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2010-10-20 |