Healthcare Provider Details

I. General information

NPI: 1285206375
Provider Name (Legal Business Name): CARE BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 07/16/2021
Certification Date: 06/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18482 KUYKENDAHL RD STE 166
SPRING TX
77379-8123
US

IV. Provider business mailing address

18482 KUYKENDAHL RD STE 166
SPRING TX
77379-8123
US

V. Phone/Fax

Practice location:
  • Phone: 877-712-2735
  • Fax:
Mailing address:
  • Phone: 877-712-2735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: KRISTA ELDER
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 925-233-5262