| NPI | 1578104154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLUBUKOLA KOMOLAFE Medical Director 832-542-3181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261Q00000X Clinic/Center | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 261QP2300X Clinic/Center Primary Care | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2022-03-29 |