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General NPI Number Information
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NPI Number | 1316385149
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Entity Type | Organization
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Legal Business Name | METROCARE MHMR
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Dates
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Enumeration Date | 06/14/2013
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 1380 RIVER BEND DR
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City | DALLAS
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State | TX
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Zip | 75247
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Country | US
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Telephone | 214-743-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 6035 WINDBREAK TRAIL
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City | DALLAS
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State | TX
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Zip | 75252
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Country | US
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Telephone | 214-518-9749
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Fax |
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Authorized Official
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Title or Position | DIRECTOR CER
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Name | ELISA KERR REES
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Credential | MA, LPC
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Telephone | 214-518-9749
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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 | 63848
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License Number State | TX
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