MEDICARE: NEXT STEP ADDICTION SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	26057	TX

General Provider Information

NPI Number	:	1134385305
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEXT STEP ADDICTION SERVICES

Provider Business Mailing Address
First Line	:	5785 GREENSPOINT DR
Second Line	:	#915
City	:	FORT WORTH
State	:	TX
Zip	:	76112-2435
Country	:	US
Telephone Number	:	469-328-8810
Fax Number	:

Provider Business Practice Location Address
First Line	:	5785 GREENSPOINT DR
Second Line	:	#915
City	:	FORT WORTH
State	:	TX
Zip	:	76112-2435
Country	:	US
Telephone Number	:	469-328-8810
Fax Number	:

Authorized Official
Title or Position	:	PROPRIETOR
Name	:	LISA J HENRY
Credential	:	LMSW
Telephone Number	:	469-328-8810

Provider Enumeration Date	:	08/06/2008
Last Update Date	:	08/06/2008

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Directions to “NEXT STEP ADDICTION SERVICES ” Practice Location

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