| NPI | 1700170610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE ANTONIO GONZALES Executive Director 817-504-4270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TX 27167) |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2011-08-14 |