| NPI | 1790026359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRISCILLA SOUZA Sole Proprietor 469-360-7453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 32008) |
| Enumeration Date | 2013-03-07 |
| Last Update Date | 2013-03-07 |