| NPI | 1609167469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL S ACEVES Sponsor 972-446-0972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: TX TX10127M) |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2023-03-07 |