| NPI | 1871970756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEMECE MICHELLE GASAWAY Director Of Licensing 214-365-6126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 251S00000X |
| 302R00000X Health Maintenance Organization | |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2019-02-21 |