| 360 Behavioral Health Of Texas Llc | |
|
120 E South Town Dr Tyler TX 75703-4747 | |
| (903) 630-7077 | |
| Not Available |
| Full Name | 360 Behavioral Health Of Texas Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 120 E South Town Dr, Tyler, Texas |
| Authorized Official Name and Position | Dennis Kogod (EXECUTIVE CHAIRMAN/CEO) |
| Authorized Official Contact | 9492858969 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 360 Behavioral Health Of Texas Llc 16946 Sherman Way Van Nuys CA 91406-3613 Ph: (949) 339-0401 | 360 Behavioral Health Of Texas Llc 120 E South Town Dr Tyler TX 75703-4747 Ph: (903) 630-7077 |
| NPI Number | 1720543895 |
|---|---|
| Provider Enumeration Date | 02/04/2019 |
| Last Update Date | 02/04/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720543895 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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