| NPI | 1538997507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YUAN YAO Owner 469-271-7480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2024-07-22 |
| Last Update Date | 2024-07-22 |