| NPI | 1780961920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANY A CHERIAN President 979-779-4756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: TX 3474-3475) |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty (Licence: TX 3474-3475) |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2011-11-15 |