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1019 S Collegiate Dr Paris TX 75460-6309 | |
| (903) 517-4063 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1019 S Collegiate Dr, Paris, Texas |
| Authorized Official Name and Position | Sequoia Brown (CLINICAL DIRECTOR) |
| Authorized Official Contact | 9035174063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1019 S Collegiate Dr Paris TX 75460-6309 Ph: (903) 517-4063 | 1019 S Collegiate Dr Paris TX 75460-6309 Ph: (903) 517-4063 |
| NPI Number | 1831588557 |
|---|---|
| Provider Enumeration Date | 01/19/2015 |
| Last Update Date | 01/19/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831588557 | NPI | - | NPPES |
| 20044900B | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 5369 (Oklahoma) | Secondary |
| 251S00000X | Community/behavioral Health | 72961 (Texas) | Primary |
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