| NPI | 1477928844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY H EZELL Owner 214-957-0951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 65384) |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2015-12-09 |