| NPI | 1972037091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIANNE RICHARDSON Owner 832-420-3628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20171240254) |
| Enumeration Date | 2017-04-14 |
| Last Update Date | 2018-05-30 |