| NPI | 1891592085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAUL JIMENEZ Owner 747-374-6471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2025-02-26 |
| Last Update Date | 2025-11-20 |