| NPI | 1790141745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATRINA JEANETTE WILL Owner 817-760-0333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: TX 201959) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: TX 201959) |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: TX 201959) | |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2016-01-06 |