| NPI | 1891246658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEMECE GASAWAY Director Of Licensing 214-365-6126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: TN I000000019002) |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2020-12-02 |