| NPI | 1669186185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELICA TIBECA MATTHEWS Manager 682-294-9632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2023-01-24 |