| Midcities Center For Change, Llc | |
|
610 S Industrial Blvd Suite 307 Euless TX 76040-5048 | |
| (817) 917-2335 | |
| Not Available |
| Full Name | Midcities Center For Change, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 610 S Industrial Blvd, Euless, Texas |
| Authorized Official Name and Position | Ken Alvin Bennett (PARTNER) |
| Authorized Official Contact | 8179172335 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midcities Center For Change, Llc 610 S Industrial Blvd Suite 307 Euless TX 76040-5048 Ph: () - | Midcities Center For Change, Llc 610 S Industrial Blvd Suite 307 Euless TX 76040-5048 Ph: (817) 917-2335 |
| NPI Number | 1427354729 |
|---|---|
| Provider Enumeration Date | 02/03/2011 |
| Last Update Date | 02/03/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427354729 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 50547 (Texas) | Primary |
| 251S00000X | Community/behavioral Health | 65300 (Texas) | Secondary |
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