| Heroic Love Inc | |
|
825 Canyon Pl Desoto TX 75115-6372 | |
| (214) 236-8567 | |
| Not Available |
| Full Name | Heroic Love Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 825 Canyon Pl, Desoto, Texas |
| Authorized Official Name and Position | Brittany N Manning (PROGRAM DIRECTOR) |
| Authorized Official Contact | 2142368567 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Heroic Love Inc 539 W Commerce St Ste 1113 Dallas TX 75208-1953 Ph: (214) 236-8567 | Heroic Love Inc 825 Canyon Pl Desoto TX 75115-6372 Ph: (214) 236-8567 |
| NPI Number | 1154912400 |
|---|---|
| Provider Enumeration Date | 01/29/2021 |
| Last Update Date | 01/29/2021 |
| Certification Date | 01/29/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154912400 | NPI | - | NPPES |
| 359047301 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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