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201 Enterprise Ave Ste 300 League City TX 77573-3085 | |
| (281) 207-0788 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 201 Enterprise Ave Ste 300, League City, Texas |
| Authorized Official Name and Position | Tara Warner (CLINICAL DIRECTOR) |
| Authorized Official Contact | 8328193339 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
999 N Egret Bay Blvd League City TX 77573-2632 Ph: () - | 201 Enterprise Ave Ste 300 League City TX 77573-3085 Ph: (281) 207-0788 |
| NPI Number | 1528797438 |
|---|---|
| Provider Enumeration Date | 06/07/2022 |
| Last Update Date | 05/17/2023 |
| Certification Date | 05/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528797438 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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