| NPI | 1891442141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC MAKOWSKI Member 512-826-1243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 261QR0400X Clinic/Center Rehabilitation |
| Enumeration Date | 2022-03-07 |
| Last Update Date | 2022-03-07 |