| NPI | 1649664897 |
|---|---|
| Other Name | MATTIE'S RANCH |
| Entity Type | Organization |
| Authorized Contact | MARC A. VALENTI Manager 817-586-8527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 21805) |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2015-10-05 |