Healthcare Provider Details

I. General information

NPI: 1932572302
Provider Name (Legal Business Name): RSQ MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2015
Last Update Date: 11/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 RUGGED DR
RED OAK TX
75154-3015
US

IV. Provider business mailing address

421 RUGGED DR
RED OAK TX
75154-3015
US

V. Phone/Fax

Practice location:
  • Phone: 469-337-8691
  • Fax:
Mailing address:
  • Phone: 469-337-8691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: MR. RODERICK SMITH
Title or Position: OWNER
Credential:
Phone: 469-337-8691