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General NPI Number Information
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NPI Number | 1205231198
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Entity Type | Organization
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Legal Business Name | ST. MARY'S II CENTER FOR EXCEPTIONAL CHILDREN,LLC
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Dates
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Enumeration Date | 11/04/2014
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Last Update Date | 11/04/2014
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Provider Practice Location Address
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Address Line | 2300 HIGHLAND VILLAGE RD BUILDING 8, SUITE 810
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City | HIGHLAND VILLAGE
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State | TX
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Zip | 75077-7148
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Country | US
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Telephone | 972-966-1080
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 HIGHLAND VILLAGE RD BUILDING 8, SUITE 810
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City | HIGHLAND VILLAGE
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State | TX
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Zip | 75077-7148
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Country | US
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Telephone | 972-966-1080
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. RAYMOND C POWER SR.
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Credential |
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Telephone | 972-966-1080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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