| NPI | 1598305567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY W GUNN Clinical Director 210-557-4884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2020-01-08 |
| Last Update Date | 2023-09-18 |