NPI | 1568341014 |
---|---|
Entity Type | Organization |
Authorized Contact | BRENNA ANSLEY Sole Member 512-537-0453 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2025-08-28 |
Last Update Date | 2025-08-28 |