| NPI | 1902597446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARYN MILLER Lpc 210-725-5570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-05-16 |
| Last Update Date | 2024-02-28 |