| NPI | 1649345869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE SUZANNE APONTE-PACHECO Chief Of Revenue Cycle 915-887-3410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: TX 101011) |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM2800X Clinic/Center Methadone | |
| 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2025-08-12 |