| NPI | 1699152330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA Y FUENTES Clinical Director 254-732-2262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: 1-15-18133) |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2015-05-01 |