Healthcare Provider Details

I. General information

NPI: 1962282954
Provider Name (Legal Business Name): GUIDED CARE MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2023
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 LITTLE ELM PKWY STE 1803
LITTLE ELM TX
75068-2503
US

IV. Provider business mailing address

2601 LITTLE ELM PKWY STE 1803
LITTLE ELM TX
75068-2503
US

V. Phone/Fax

Practice location:
  • Phone: 469-386-4246
  • Fax:
Mailing address:
  • Phone: 469-386-4246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: TYNESHA PARKS
Title or Position: DIRECTOR
Credential:
Phone: 469-386-4246