| NPI | 1568226025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASMINE N RANDOLPH Owner 832-730-9817 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251B00000X Case Management | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2024-02-06 |
| Last Update Date | 2024-02-06 |