| NPI | 1952357550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNIE J SMITH Reimbursement Manager 409-839-1009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology |
| 251B00000X Case Management | |
| 251K00000X Public Health or Welfare | |
| 101YM0800X Counselor, Mental Health | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2022-12-05 |