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General NPI Number Information
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NPI Number | 1336412840
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Entity Type | Organization
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Legal Business Name | MULTICULTURAL CENTER
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Dates
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Enumeration Date | 02/14/2012
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Last Update Date | 02/14/2012
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Provider Practice Location Address
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Address Line | 5026 ROSS AVE STE 3
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City | DALLAS
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State | TX
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Zip | 75206-7707
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Country | US
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Telephone | 214-609-3300
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Fax | 325-574-1333
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Provider Business Mailing Address
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Address Line | 5026 ROSS AVE STE 3
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City | DALLAS
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State | TX
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Zip | 75206-7707
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Country | US
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Telephone | 214-609-3300
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Fax | 325-574-1333
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Authorized Official
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Title or Position | OWNER
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Name | MS. SHIRLEY ANN POECK
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Credential | LPC
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Telephone | 214-609-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 16128
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 16128
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 16128
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License Number State | TX
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