| NPI | 1962539569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES RUSSEL VAN NORMAN Medical Director 512-440-4021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-08-22 |