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 Clinic/Center, Mental Health (Including Community Mental Health Center) | |
261QM2800X Clinic/Center, Methadone Clinic | |
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
Enumeration Date | 2014-12-08 |
Last Update Date | 2020-05-29 |