| NPI | 1700639168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNDA JOHNSON Director 469-600-6366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 171400000X |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2024-04-08 |
| Last Update Date | 2024-04-08 |