NPI | 1558190405 |
---|---|
Entity Type | Organization |
Authorized Contact | MONICA RENEA GRAY CEO 469-441-6163 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
Additional Taxonomies | 251S00000X |
Enumeration Date | 2024-07-30 |
Last Update Date | 2024-11-10 |