| On-site Crisis Intervention Llc | |
|
851 Gomez Rd El Paso TX 79932-4205 | |
| (915) 525-2796 | |
| (915) 581-6708 |
| Full Name | On-site Crisis Intervention Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 851 Gomez Rd, El Paso, Texas |
| Authorized Official Name and Position | Diane Hardwick Bryan (OWNER/CLINICAL COUNSELOR) |
| Authorized Official Contact | 9155252796 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| On-site Crisis Intervention Llc 851 Gomez Rd El Paso TX 79932-4205 Ph: (915) 525-2796 | On-site Crisis Intervention Llc 851 Gomez Rd El Paso TX 79932-4205 Ph: (915) 525-2796 |
| NPI Number | 1720341753 |
|---|---|
| Provider Enumeration Date | 06/25/2012 |
| Last Update Date | 10/16/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720341753 | NPI | - | NPPES |
| 13623745 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 7697 (Texas) | Secondary |
| 101YP2500X | Counselor - Professional | 62311 (Texas) | Primary |
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