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General NPI Number Information
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NPI Number | 1275472862
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Entity Type | Organization
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Legal Business Name | THREE LIGHTS COMMUNITY HEALTH OUTREACH CLINIC INC
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Dates
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Enumeration Date | 03/27/2026
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Last Update Date | 03/27/2026
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Provider Practice Location Address
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Address Line | 1017 BURNET DR
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City | MESQUITE
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State | TX
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Zip | 75181-2696
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Country | US
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Telephone | 214-962-4537
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Fax | 972-544-1517
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Provider Business Mailing Address
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Address Line | 1017 BURNET DR
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City | MESQUITE
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State | TX
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Zip | 75181-2696
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Country | US
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Telephone | 214-962-4537
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Fax | 972-544-1517
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. HASSANATU MICHAEL
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Credential | MICHAEL
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Telephone | 214-962-4537
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 364SF0001X
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Taxonomy Name | Family Health Clinical Nurse Specialist
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License Number |
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License Number State |
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