| NPI | 1447852116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA WILLSON Registered Agent 972-214-4833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-11-09 |
| Last Update Date | 2024-07-03 |