| NPI | 1538659412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEONARD MADISON MARSHALL Owner 832-683-5150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 76425) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 4440) |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2018-06-04 |