Healthcare Provider Details

I. General information

NPI: 1578685756
Provider Name (Legal Business Name): METROCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3021 SOUTHERN HILLS LN
MESQUITE TX
75181-4038
US

IV. Provider business mailing address

1353 N WESTMORELAND RD
DALLAS TX
75211-1655
US

V. Phone/Fax

Practice location:
  • Phone: 214-641-4577
  • Fax:
Mailing address:
  • Phone: 214-333-7031
  • Fax: 214-467-7520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number15002
License Number StateTX

VIII. Authorized Official

Name: MR. RABIU E OMOLAJA
Title or Position: COUNSELOR
Credential: LPC
Phone: 214-333-7031