| Waterford Academy Llc | |
|
1033 Long Prairie Rd Ste 3 Flower Mound TX 75022-4230 | |
| (972) 355-9083 | |
| Not Available |
| Full Name | Waterford Academy Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1033 Long Prairie Rd Ste 3, Flower Mound, Texas |
| Authorized Official Name and Position | Mark Petty (OWNER) |
| Authorized Official Contact | 9723655318 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Waterford Academy Llc 1033 Long Prairie Rd Ste 3 Flower Mound TX 75022-4230 Ph: (972) 355-9083 | Waterford Academy Llc 1033 Long Prairie Rd Ste 3 Flower Mound TX 75022-4230 Ph: (972) 355-9083 |
| NPI Number | 1205256211 |
|---|---|
| Provider Enumeration Date | 04/17/2014 |
| Last Update Date | 04/17/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205256211 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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