| NPI | 1629582028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH R WARD Authorized Official 915-532-3790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2021-02-01 |