| NPI | 1982300588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMONICK FITZGERALD CRANE Owner, Provider 832-720-2149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2023-02-06 |
| Last Update Date | 2023-02-06 |