| NPI | 1801665484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLI FOULKROD Owner 512-200-3359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 374K00000X | |
| Enumeration Date | 2023-12-25 |
| Last Update Date | 2023-12-25 |