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General NPI Number Information
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NPI Number | 1750058103
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Entity Type | Organization
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Legal Business Name | LAKE POINTE RESOURCE CENTER, INC.
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Dates
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Enumeration Date | 08/24/2021
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 1260 WEATHERFORD HWY
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City | GRANBURY
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State | TX
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Zip | 76048-4822
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Country | US
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Telephone | 682-333-1555
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Fax | 817-717-2378
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Provider Business Mailing Address
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Address Line | 1260 WEATHERFORD HWY
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City | GRANBURY
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State | TX
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Zip | 76048-4822
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Country | US
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Telephone | 682-333-1555
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Fax | 817-717-2378
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MADALYN CANO
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Credential | MSSW, LCSW
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Telephone | 682-333-1555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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