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General NPI Number Information
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NPI Number | 1386336261
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Entity Type | Organization
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Legal Business Name | K-NATION GROUP
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Dates
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Enumeration Date | 05/22/2023
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 9535 FOREST LN STE 124
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City | DALLAS
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State | TX
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Zip | 75243-5910
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Country | US
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Telephone | 512-574-8840
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Fax |
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Provider Business Mailing Address
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Address Line | 801 SMOTHERMON FARM RD
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City | LITTLE ELM
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State | TX
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Zip | 75068-1009
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Country | US
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Telephone | 512-574-8840
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ALEXIS MASTON
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Credential | PHD
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Telephone | 512-574-8840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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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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Taxonomy #5
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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