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General NPI Number Information
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NPI Number | 1609496488
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Entity Type | Organization
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Legal Business Name | CAGNOLATTI AND HENDERSON INC.
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Dates
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Enumeration Date | 04/21/2020
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Last Update Date | 04/21/2020
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Provider Practice Location Address
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Address Line | 1451 EMPIRE CENTRAL DR STE 900
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City | DALLAS
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State | TX
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Zip | 75247-4096
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Country | US
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Telephone | 469-360-6794
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Fax |
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Provider Business Mailing Address
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Address Line | 3543 RIO GRANDE CIR
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City | DALLAS
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State | TX
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Zip | 75233-2553
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAKISHA HENDERSON
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Credential |
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Telephone | 469-360-6794
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number |
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License Number State |
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