| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2124 N 25th St, Waco, Texas |
| Authorized Official Name and Position | Steven Wayne Carter (CEO) |
| Authorized Official Contact | 2542357604 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2124 N 25th St Waco TX 76708 Ph: (254) 235-7604 | 2124 N 25th St Waco TX 76708-3317 Ph: (254) 235-7604 |
| NPI Number | 1215267406 |
|---|---|
| Provider Enumeration Date | 01/11/2010 |
| Last Update Date | 01/11/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215267406 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 14119 (Texas) | Primary |
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