| NPI | 1760841043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELICIA A NEISSER Revenue Analyst 361-575-0611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2016-02-16 |
| Last Update Date | 2016-02-16 |