| NPI | 1477052959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VENESA L HINES Contracted 210-683-9747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20181100355) |
| Enumeration Date | 2018-02-09 |
| Last Update Date | 2018-02-09 |