| NPI | 1568241149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY WHITTED Owner 940-553-0837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2023-09-25 |