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General NPI Number Information
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NPI Number | 1285843227
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Entity Type | Organization
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Legal Business Name | MAURICE BARNETT GERIATRIC WELLNESS CENTER, INC.
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 401 W 16TH ST STE 600
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City | PLANO
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State | TX
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Zip | 75075-7005
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Country | US
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Telephone | 972-941-7335
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Fax | 972-516-4870
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Provider Business Mailing Address
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Address Line | 401 W 16TH ST STE 600
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City | PLANO
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State | TX
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Zip | 75075-7005
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Country | US
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Telephone | 972-941-7335
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Fax | 972-516-4870
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. CAROLYN RICE
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Credential | R.N., M.S.N.,M.P.A.
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Telephone | 972-941-7335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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