| NPI | 1912651407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRODY SMITH Manager 806-669-7976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-02-04 |
| Last Update Date | 2022-02-04 |