| NPI | 1922507821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED BREWER Owner 385-528-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 7738832-3501) |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2018-02-06 |