| NPI | 1790276558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIMPLE SHAH RAJA Lpc 972-357-6387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: TX 72870) |
| Enumeration Date | 2018-05-28 |
| Last Update Date | 2021-01-31 |