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11801 South Fwy Burleson TX 76028-7021 | |
| (817) 293-9110 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 11801 South Fwy, Burleson, Texas |
| Authorized Official Name and Position | Penny Johnson (PRESIDENT, REGIONAL CEO) |
| Authorized Official Contact | 8175512740 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 6452 Fort Worth TX 76115-0452 Ph: (817) 551-2721 | 11801 South Fwy Burleson TX 76028-7021 Ph: (817) 293-9110 |
| NPI Number | 1518355759 |
|---|---|
| Provider Enumeration Date | 12/22/2014 |
| Last Update Date | 11/20/2024 |
| Certification Date | 11/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518355759 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 100157 (Texas) | Primary |
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