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 |