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101 E Park Blvd Suite 202 Plano TX 75074-5483 | |
| (972) 424-5659 | |
| (972) 424-5653 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 101 E Park Blvd, Plano, Texas |
| Authorized Official Name and Position | Michelle Adams (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9724245659 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
12300 Hunters Creek Rd College Station TX 77845-7524 Ph: (979) 690-2220 | 101 E Park Blvd Suite 202 Plano TX 75074-5483 Ph: (972) 424-5659 |
| NPI Number | 1073934055 |
|---|---|
| Provider Enumeration Date | 12/18/2013 |
| Last Update Date | 12/18/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073934055 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 3695-3696 (Texas) | Primary |
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