| NPI | 1609103456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON ANDREA JOHNSON President 817-283-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: TX k7174) |
| Enumeration Date | 2009-11-14 |
| Last Update Date | 2010-02-01 |