| NPI | 1689108946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN GOODWIN Owner 972-754-8086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 66602) |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2017-04-13 |