| NPI | 1508653445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBEREY CALLOWAY Administrator 682-326-6295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2025-04-23 |
| Last Update Date | 2025-04-23 |