| NPI | 1861860892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL THOMPSON Data Admin 254-752-3451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2015-09-08 |
| Last Update Date | 2020-03-05 |