| NPI | 1568959658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WHITNEY M SUTHERLAND Owner 512-761-8746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 76163) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2019-06-11 |