Healthcare Provider Details

I. General information

NPI: 1164174330
Provider Name (Legal Business Name): RFAA FOUNDATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2022
Last Update Date: 01/19/2022
Certification Date: 01/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2307 BRITTON DR
DALLAS TX
75216-2401
US

IV. Provider business mailing address

2307 BRITTON DR
DALLAS TX
75216-2401
US

V. Phone/Fax

Practice location:
  • Phone: 214-454-7981
  • Fax:
Mailing address:
  • Phone: 214-454-7981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. BRUCE CARTER
Title or Position: FOUNDER
Credential:
Phone: 202-907-1760