Healthcare Provider Details

I. General information

NPI: 1457736167
Provider Name (Legal Business Name): THE ACADEMY AT MHA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2015
Last Update Date: 07/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7604 SAN JACINTO PL
PLANO TX
75024-3237
US

IV. Provider business mailing address

7604 SAN JACINTO PL
PLANO TX
75024-3237
US

V. Phone/Fax

Practice location:
  • Phone: 972-208-9500
  • Fax:
Mailing address:
  • Phone: 972-208-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberG9499
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberG9499
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License NumberG9499
License Number StateTX

VIII. Authorized Official

Name: ARNOLD WALTER MECH
Title or Position: PRESIDENT/MEDICAL DIRECTOR
Credential: M.D.
Phone: 972-208-9500