| NPI | 1740060326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACEY DARLENE LUNDGREN Owner 512-413-5190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-10-02 |
| Last Update Date | 2023-10-13 |