| Magnolia Therapeutic Services | |
|
1630 Falcon Dr Suite 104 Desoto TX 75115-2416 | |
| (281) 630-2328 | |
| Not Available |
| Full Name | Magnolia Therapeutic Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1630 Falcon Dr, Desoto, Texas |
| Authorized Official Name and Position | Shakeithdra Rashae Lee (RN - CASE MANAGER) |
| Authorized Official Contact | 2816302328 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Therapeutic Services 1630 Falcon Dr Suite 104 Desoto TX 75115-2416 Ph: (281) 630-2328 | Magnolia Therapeutic Services 1630 Falcon Dr Suite 104 Desoto TX 75115-2416 Ph: (281) 630-2328 |
| NPI Number | 1578098406 |
|---|---|
| Provider Enumeration Date | 04/28/2017 |
| Last Update Date | 10/02/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578098406 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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