| Branch Of Life, Inc | |
|
202 W Center St Ste F Duncanville TX 75116-3441 | |
| (972) 296-2676 | |
| Not Available |
| Full Name | Branch Of Life, Inc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 202 W Center St Ste F, Duncanville, Texas |
| Authorized Official Name and Position | Billy W Corn (CEO) |
| Authorized Official Contact | 9722962676 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Branch Of Life, Inc 8554 County Road 4023 Kemp TX 75143-4354 Ph: (972) 296-2676 | Branch Of Life, Inc 202 W Center St Ste F Duncanville TX 75116-3441 Ph: (972) 296-2676 |
| NPI Number | 1609173889 |
|---|---|
| Provider Enumeration Date | 02/23/2011 |
| Last Update Date | 02/23/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609173889 | NPI | - | NPPES |
| 187018001 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
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