| NPI | 1861062168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SPENCER DICKEY Manager Payer Relations 806-928-2447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RG0300X Internal Medicine Geriatric Medicine | |
| 207Q00000X Family Medicine | |
| 208000000X Pediatrics | |
| 208D00000X General Practice | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2025-02-10 |