| NPI | 1992241400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEMECE MICHELLE GASAWAY Director Of Licensing 214-365-6126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: GA NTP001047) |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: GA NTP001047) |
| 261QM2800X Clinic/Center Methadone (Licence: GA NTP001047) | |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2019-02-20 |