| NPI | 1982223194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BISRAT MESFIN Medical Director 512-947-2747 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2020-04-09 |