| NPI | 1932617552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN CUMMINGS Owner 469-878-0492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 61709) |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2018-01-17 |