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NPI Code Detail

MEDICARE: DRD MANAGEMENT, INC

MEDICARE: DRD MANAGEMENT, INC
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
2261QM2800XMethadone Clinic
3261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center1305-1MO

General Provider Information

NPI Number : 1366603623
Entity Type Code : Organization
Provider Name (Legal Business Name) : DRD MANAGEMENT, INC
Provider Business Mailing Address
First Line : 5001 SPRING VALLEY ROAD
Second Line : SUITE 600 EAST
City : DALLAS
State : TX
Zip : 75244
Country : US
Telephone Number : 214-365-6100
Fax Number : 214-365-6150
Provider Business Practice Location Address
First Line : 1301 VANDIVER DR STE Y
Second Line :
City : COLUMBIA
State : MO
Zip : 65202-3918
Country : US
Telephone Number : 573-449-8338
Fax Number : 573-449-8344
Authorized Official
Title or Position : CEO
Name : JAY HIGHAM
Credential :
Telephone Number : 214-365-6112
Provider Enumeration Date : 06/19/2008
Last Update Date : 12/26/2024

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