| NPI | 1629476627 |
|---|---|
| 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 |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 207P00000X Emergency Medicine | |
| 261QM0801X | |
| 261QM2800X Clinic/Center, Methadone Clinic | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2020-05-29 |