| NPI | 1700581337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAYO IVYL OWENS Np 832-258-0772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2024-02-19 |