| NPI | 1811242522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELODY M MOORE President 832-264-4454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 34928) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: TX 34928) |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2018-11-26 |