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4800 Sugar Grove Blvd Ste 275 Stafford TX 77477-2150 | |
| (888) 491-4177 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4800 Sugar Grove Blvd Ste 275, Stafford, Texas |
| Authorized Official Name and Position | Laura J Brown (VP OF REVENUE CYCLE MANAGEMENT) |
| Authorized Official Contact | 6618294060 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5500 Ming Ave Ste 410 Bakersfield CA 93309-4631 Ph: (661) 622-4132 | 4800 Sugar Grove Blvd Ste 275 Stafford TX 77477-2150 Ph: (888) 491-4177 |
| NPI Number | 1013635085 |
|---|---|
| Provider Enumeration Date | 08/16/2022 |
| Last Update Date | 06/20/2023 |
| Certification Date | 06/20/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013635085 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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