Healthcare Provider Details

I. General information

NPI: 1295375632
Provider Name (Legal Business Name): ASCEND BEHAVIORAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2020
Last Update Date: 01/14/2020
Certification Date: 01/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 SPUR 156
WASKOM TX
75692-9101
US

IV. Provider business mailing address

495 SPUR 156
WASKOM TX
75692-9101
US

V. Phone/Fax

Practice location:
  • Phone: 318-617-3504
  • Fax:
Mailing address:
  • Phone: 318-617-3504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: LABRITTANI JAMES
Title or Position: MANAGER
Credential:
Phone: 318-617-3504