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General NPI Number Information
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NPI Number | 1578080776
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Entity Type | Organization
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Legal Business Name | 4 H COUNSELING CENTER, LLC.
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Dates
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Enumeration Date | 08/28/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 600 STRADA CIRCLE #216
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City | MANSFIELD
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State | TX
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Zip | 76063
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Country | US
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Telephone | 817-754-0442
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Fax | 817-225-4744
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Provider Business Mailing Address
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Address Line | 600 STRADA CIR STE 216
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City | MANSFIELD
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State | TX
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Zip | 76063-3209
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Country | US
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Telephone | 817-754-0442
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Fax | 817-225-4744
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Authorized Official
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Title or Position | CEO/MANAGING DIRECTOR
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Name | MECHELLE NELSON
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Credential |
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Telephone | 817-938-3872
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 600085
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License Number State | TX
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