| NPI | 1881114866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDREY FUTRELL Owner 469-556-1081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: TX 69730) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: TX 12817) |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: TX 69730) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: TX 12817) | |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2022-07-21 |