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206 N State St Ste 100 Decatur TX 76234-2289 | |
| (940) 577-1848 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 206 N State St Ste 100, Decatur, Texas |
| Authorized Official Name and Position | Jeri Kay Long-kao (OWNER) |
| Authorized Official Contact | 9405771848 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 477 Decatur TX 76234-0477 Ph: (940) 577-1848 | 206 N State St Ste 100 Decatur TX 76234-2289 Ph: (940) 577-1848 |
| NPI Number | 1992456776 |
|---|---|
| Provider Enumeration Date | 01/13/2022 |
| Last Update Date | 01/22/2024 |
| Certification Date | 01/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992456776 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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