| NPI | 1982393724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHLYN MARIE FRAGUELA RIOS Owner 765-491-1415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2023-05-08 |