| NPI | 1679340525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NDI ESIERE Nurse Practitioner 832-836-0275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QM2500X Clinic/Center, Medical Specialty | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QR1300X Clinic/Center, Rural Health | |
| 310400000X Assisted Living Facility | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| 314000000X Skilled Nursing Facility | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2023-12-11 |
| Last Update Date | 2023-12-11 |