Healthcare Provider Details

I. General information

NPI: 1396604252
Provider Name (Legal Business Name): CENTRAL MANAGEMENT SERVICES ORGANIZATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2026
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 WESTPARK WAY
EULESS TX
76040-3963
US

IV. Provider business mailing address

200 WESTPARK WAY
EULESS TX
76040-3963
US

V. Phone/Fax

Practice location:
  • Phone: 954-507-6634
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ISHRAT KHURSHID I
Title or Position: MANAGER
Credential:
Phone: 954-507-6634