| NPI | 1821979527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN JEFFERSON Manager 469-584-0824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0812X Clinical Nurse Specialist, Psych/Mental Health, Community |
| Additional Taxonomies | 251B00000X Case Management |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2025-09-09 |
| Last Update Date | 2026-01-12 |