| NPI | 1942192232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL TENNYSON TOLL Managing Member 512-663-3142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-07-19 |
| Last Update Date | 2025-08-28 |