| NPI | 1659713659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP JOHNSON Sole Member 210-913-7445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 63494) |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2013-07-19 |