| NPI | 1689022055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SVIATLANA PETROVNA LOCANTO Owner 817-668-5497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: PA 130453) |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2016-05-26 |