| NPI | 1548069859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID J MORAINE Legal Counsel 469-990-3626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-03-10 |
| Last Update Date | 2025-04-15 |