| NPI | 1609610831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOGEN ASHFORD Owner 903-491-6950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-06-21 |
| Last Update Date | 2025-09-22 |