| Live Young, Pa | |
|
7515 Greenville Ave Suite 1005 Dallas TX 75231-3831 | |
| (214) 369-8717 | |
| (214) 369-7937 |
| Full Name | Live Young, Pa |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 7515 Greenville Ave, Dallas, Texas |
| Authorized Official Name and Position | Jordan Pastorek (FOUNDER) |
| Authorized Official Contact | 2143698717 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Live Young, Pa 7515 Greenville Ave Suite 1005 Dallas TX 75231-3831 Ph: (214) 369-8717 | Live Young, Pa 7515 Greenville Ave Suite 1005 Dallas TX 75231-3831 Ph: (214) 369-8717 |
| NPI Number | 1497137830 |
|---|---|
| Provider Enumeration Date | 06/22/2015 |
| Last Update Date | 06/22/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497137830 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | M1286 (Texas) | Primary |
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