| NPI | 1871648816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK CHARLES Rev 832-878-2954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2012-03-16 |