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250 College Ave Keller TX 76248-3449 | |
| (817) 447-3001 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 250 College Ave, Keller, Texas |
| Authorized Official Name and Position | Jeff Isaac (CONTROLLER) |
| Authorized Official Contact | 7329277080 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 446 Lakewood NJ 08701-0446 Ph: () - | 250 College Ave Keller TX 76248-3449 Ph: (817) 447-3001 |
| NPI Number | 1790239648 |
|---|---|
| Provider Enumeration Date | 08/09/2016 |
| Last Update Date | 11/03/2023 |
| Certification Date | 11/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790239648 | NPI | - | NPPES |
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