| NPI | 1750521175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILL WOODBURN Director 512-458-2875 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX LPC 10121) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2009-02-25 |
| Last Update Date | 2021-05-24 |