| NPI | 1740168160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHALAN COSTA CEO 915-239-8394 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-08-25 |
| Last Update Date | 2025-08-25 |