| NPI | 1629567904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZAVETA POTAPENKO President 512-710-7203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: TX 36269) |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2018-05-02 |