| NPI | 1457734352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY MARTEZ PITTMAN Owner 800-419-2568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 67531) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 9583) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2015-07-09 |