| NPI | 1922516038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AIMEE TANOS Managing Member 817-726-8927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 62538) |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2026-05-13 |