| NPI | 1790158384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RON STEIN Clinical Director 817-919-6674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: TX 71047) |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2015-11-04 |