| NPI | 1861374555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW A ALDER Owner 469-866-8526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-07-23 |
| Last Update Date | 2025-08-03 |