| NPI | 1932882800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL BOYLE Director, Credentialing 512-765-9003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2025-08-20 |