| NPI | 1679258354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNNE JACKSON Owner 210-313-1760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-06-20 |
| Last Update Date | 2023-06-20 |