| NPI | 1609491273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI L EDWARDS VP 817-966-2764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM2800X Clinic/Center Methadone |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2022-01-18 |