| NPI | 1710146139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANA JEAN CONOVER Owner 903-534-6240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: TX 18503) |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2009-06-16 |