| NPI | 1710364153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILL KELLY Executive Director 979-822-6467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2025-01-29 |