| NPI | 1720858657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNIE MOUSER Credentialing 903-716-6602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-01-02 |
| Last Update Date | 2024-01-23 |