| NPI | 1649781618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN LAVENE Provider 214-833-8454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: TX 72975) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2021-02-08 |