| NPI | 1760250203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA RENEA GRAY CEO 469-441-6163 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2023-12-14 |
| Last Update Date | 2025-08-11 |