| NPI | 1861983504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERMANY WILLIAMS Administrator 972-789-5199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171W00000X Contractor |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 172V00000X Community Health Worker | |
| 221700000X Art Therapist | |
| 2255A2300X Specialist/Technologist Athletic Trainer | |
| 225700000X Massage Therapist | |
| 225800000X Recreation Therapist | |
| 225A00000X Music Therapist | |
| 251S00000X Community/Behavioral Health | |
| 305R00000X Preferred Provider Organization | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2019-08-22 |