| NPI | 1881183523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL WURTH CEO 210-920-1572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 73182) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 12744) |
| Enumeration Date | 2018-05-08 |
| Last Update Date | 2019-09-25 |