| NPI | 1629728423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMIAH GRIMES Proprietor 214-288-9508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-03-24 |
| Last Update Date | 2022-03-24 |