Healthcare Provider Details

I. General information

NPI: 1992264402
Provider Name (Legal Business Name): CITADEL BEHAVIORAL HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2019
Last Update Date: 03/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 NORTHWEST HWY STE 206
GARLAND TX
75041-5896
US

IV. Provider business mailing address

3802 CITADEL DR
GARLAND TX
75040-1081
US

V. Phone/Fax

Practice location:
  • Phone: 469-434-1145
  • Fax: 463-533-1769
Mailing address:
  • Phone: 469-835-7543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ADEJUMOKE DORCAS ONADEKO
Title or Position: CEO
Credential: NP
Phone: 469-835-7543