| NPI | 1487385241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM BRUGGEMAN Managing Member 210-373-3704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 2083A0300X Preventive Medicine, Addiction Medicine | |
| 208VP0000X | |
| Enumeration Date | 2022-06-22 |
| Last Update Date | 2024-11-13 |