| NPI | 1700378544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLA CANNEFAX Owner 903-330-5579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: TX 72989) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2018-12-20 |