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General NPI Number Information
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NPI Number | 1730302522
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Entity Type | Organization
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Legal Business Name | METROCARE SERVICES
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4645 SAMUELL BLVD
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City | DALLAS
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State | TX
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Zip | 75228-6826
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Country | US
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Telephone | 214-275-7393
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Fax | 214-381-6617
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Provider Business Mailing Address
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Address Line | 7432 RIDGEWICK DR
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City | DALLAS
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State | TX
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Zip | 75217-6227
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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 | QMHP
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Name | MS. THEANDREA YVONNE SANDERS
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Credential | B.S.
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Telephone | 214-275-7393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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