| NPI | 1669053047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYKIA HOLLIS-GRIFFITH Member 254-251-8750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2021-04-18 |
| Last Update Date | 2021-10-16 |