| NPI | 1831542240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAKEITHA A. MOYE PT A 267-902-7537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 2115702) |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2016-07-20 |