| NPI | 1629391198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE HOPPER Scheduling Manager 817-882-9611 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 2012118) |
| Enumeration Date | 2010-03-11 |
| Last Update Date | 2010-03-11 |