Heritage Behavioral Health Center

NPI 1053545509 - Social Worker - 1041C0700X

NPI Details
NPI 1053545509
Enumeration Date 05/13/2009
Last Updated 10/09/2009
Entity Type Healthcare Provider
Active Over 7 years ago
Authorized Information
Name JEANNE RENEE JEANNE
Position OWNER
Phone (817) 488-9697
Fax (817) 488-9656
Practice Location
2485 E SOUTHLAKE BLVD
SUITE 180
SOUTHLAKE TX, 76092-6686, US
Phone (817) 488-9697
Fax (817) 488-9656
Business Location
2485 E SOUTHLAKE BLVD
SUITE 180
SOUTHLAKE TX, 76092-6686, US
Phone (817) 488-9697
Fax (817) 488-9656
Toxanomy
Taxonomy Code 1041C0700X
License State Texas
License Number 12584
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According to our database, Heritage Behavioral Health Center NPI is 1053545509, taxonomy code is 1041C0700X and license number is 12584, license state is located at Texas. Heritage Behavioral Health Center physically located at 2485 E Southlake Blvd, Southlake TX, 76092-6686. NPI Number 1033115704 has the healthcare provider type.

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1053545509 NPI number is provided on an as is basis without warranty of any kind. 1053545509 is maintained by the National Plan & Provider Enumeration System. The contents of Heritage Behavioral Health Center are for informational purposes only.