| NPI | 1659566404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA VAN BRUNT Business Administration Manager 512-697-8518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: TX 286-286L) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: TX 286-286Y) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: TX 286-286B) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: TX 286-L) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: TX 286-286Y) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: TX 286-286B) | |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2018-08-31 |