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General NPI Number Information
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NPI Number | 1740674563
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Entity Type | Organization
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Legal Business Name | WARR ON WELLNESS, LLC
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Dates
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Enumeration Date | 03/19/2015
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Last Update Date | 03/19/2015
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Provider Practice Location Address
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Address Line | 4524 LEE ST
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City | CARROLLTON
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State | TX
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Zip | 75010-4157
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Country | US
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Telephone | 972-741-3760
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Fax |
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Provider Business Mailing Address
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Address Line | 4524 LEE ST
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City | CARROLLTON
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State | TX
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Zip | 75010-4157
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Country | US
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Telephone | 972-741-3760
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ANGELA FAYE WARR
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Credential | MA, MS, CAMS-S, PWC
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Telephone | 972-741-3760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1407249782
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License Number State | TX
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