| NPI | 1770332603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KASEE BATES Owner 512-740-6764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2024-05-14 |
| Last Update Date | 2024-05-14 |