| NPI | 1881014926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADISON ANNE CLARK Counselor 214-435-6145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 5327) |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2015-05-01 |