| NPI | 1619540077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IMELDA RAMIREZ REVERON CEO/Administrator 210-600-4117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2021-07-22 |
| Last Update Date | 2021-07-22 |