| NPI | 1912361841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN D BOYNTON Owner 903-330-6166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 34827) |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2016-04-06 |