| NPI | 1699492074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KANDICE SEVIER Owner/Director 682-877-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2022-10-26 |
| Last Update Date | 2023-08-22 |