| NPI | 1891396313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY NEULENE LINDLEY Managing Member 214-560-0304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YP2500X Counselor Professional | |
| 251K00000X Public Health or Welfare | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2020-11-02 |
| Last Update Date | 2020-11-02 |