| NPI | 1669861597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN BROCKMAN President 972-372-9644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 65542) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2015-01-15 |