| NPI | 1700252244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELITA Y WOODS Owner 682-240-8181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2015-08-19 |