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2126 Pecan Ridge Dr Forney TX 75126-4070 | |
| (214) 586-7110 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 2126 Pecan Ridge Dr, Forney, Texas |
| Authorized Official Name and Position | Marlo Snerling (CEO) |
| Authorized Official Contact | 2145867110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2126 Pecan Ridge Dr Forney TX 75126-4070 Ph: (214) 586-7110 | 2126 Pecan Ridge Dr Forney TX 75126-4070 Ph: (214) 586-7110 |
| NPI Number | 1760046502 |
|---|---|
| Provider Enumeration Date | 04/26/2019 |
| Last Update Date | 11/14/2023 |
| Certification Date | 11/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760046502 | NPI | - | NPPES |
| 834551325 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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