| NPI | 1902141542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENA PAIGE MOORE Director 806-620-9934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 16800) |
| Enumeration Date | 2012-12-08 |
| Last Update Date | 2012-12-08 |