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General NPI Number Information
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NPI Number | 1609570266
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Entity Type | Organization
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Legal Business Name | ADVANCED BEHAVIORAL CARE LLC
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Dates
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Enumeration Date | 03/28/2023
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Last Update Date | 03/28/2023
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Provider Practice Location Address
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Address Line | 1820 PRESTON PARK BLVD STE 2200
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City | PLANO
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State | TX
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Zip | 75093-3614
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Country | US
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Telephone | 972-679-7942
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Fax |
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Provider Business Mailing Address
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Address Line | 5215 AUDREY ST
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City | DALLAS
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State | TX
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Zip | 75210-3202
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Country | US
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Telephone | 972-679-7942
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARIA CAMACHO
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Credential |
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Telephone | 972-679-7942
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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