1derfull Minds | |
631 Cresent Dr Desoto TX 75115-8017 | |
(469) 235-2390 | |
(972) 637-7576 |
Full Name | 1derfull Minds |
---|---|
Speciality | Community/behavioral Health |
Location | 631 Cresent Dr, Desoto, Texas |
Authorized Official Name and Position | Ella Marie Miles (PRESIDENT/PROGRAM MANAGER) |
Authorized Official Contact | 4692352390 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
1derfull Minds 631 Cresent Dr Desoto TX 75115-8017 Ph: (469) 235-2390 | 1derfull Minds 631 Cresent Dr Desoto TX 75115-8017 Ph: (469) 235-2390 |
NPI Number | 1487318671 |
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Provider Enumeration Date | 10/25/2021 |
Last Update Date | 09/29/2023 |
Certification Date | 09/29/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487318671 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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