| Dynamic Behavioral Healthcare Services | |
|
2743 Kenedy Ln Grand Prairie TX 75052-0735 | |
| (817) 235-8869 | |
| Not Available |
| Full Name | Dynamic Behavioral Healthcare Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2743 Kenedy Ln, Grand Prairie, Texas |
| Authorized Official Name and Position | Dickson D Oyeyemi-kuteyi (OWNER) |
| Authorized Official Contact | 8172358869 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dynamic Behavioral Healthcare Services 2743 Kenedy Ln Grand Prairie TX 75052-0735 Ph: (817) 235-8869 | Dynamic Behavioral Healthcare Services 2743 Kenedy Ln Grand Prairie TX 75052-0735 Ph: (817) 235-8869 |
| NPI Number | 1801592308 |
|---|---|
| Provider Enumeration Date | 02/06/2023 |
| Last Update Date | 09/15/2023 |
| Certification Date | 09/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801592308 | NPI | - | NPPES |
| 464166401 | Medicaid | TX | |
| 467418601 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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