| NPI | 1619338696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEMECE MICHELLE GASAWAY Director Of Licensing 214-365-6126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: KS 0697003W) |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic (Licence: KS 0697003W) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: KS 0697003W) | |
| Enumeration Date | 2016-03-17 |
| Last Update Date | 2019-02-21 |