| 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 |