| NPI | 1659096949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA D. SMITH Manager 682-224-8277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-10-10 |
| Last Update Date | 2022-10-10 |