| NPI | 1710432653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMY HENRY COPELAND President 469-544-9932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 0904007292) |
| Enumeration Date | 2016-08-21 |
| Last Update Date | 2016-08-21 |