| NPI | 1831840891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKKI ORTEGA Credentialing 469-346-0136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2022-01-12 |