Healthcare Provider Details

I. General information

NPI: 1316718554
Provider Name (Legal Business Name): TREAT MENTAL HEALTH TEXAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2024
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1464 E WHITESTONE BLVD STE 1304
CEDAR PARK TX
78613-9072
US

IV. Provider business mailing address

8 THE GRN # 8973
DOVER DE
19901-3618
US

V. Phone/Fax

Practice location:
  • Phone: 512-580-7304
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TAYLOR CAVENDER
Title or Position: AUTHORIZED REPRESENTATIVE
Credential:
Phone: 512-580-7304