| NPI | 1750646527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BARCLAY JESSUP Owner 210-875-1414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 18957) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2012-07-17 |