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General NPI Number Information
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NPI Number | 1750728275
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Entity Type | Organization
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Legal Business Name | THE CENTRE FOR PASTORAL CARE AND COUNSELING
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Dates
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Enumeration Date | 05/23/2013
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Last Update Date | 05/23/2013
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Provider Practice Location Address
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Address Line | 400 HEMPHILL ST
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City | FORT WORTH
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State | TX
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Zip | 76104-2216
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Country | US
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Telephone | 817-953-3064
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Fax | 817-953-3093
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Provider Business Mailing Address
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Address Line | PO BOX 341
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City | FORT WORTH
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State | TX
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Zip | 76101-0341
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Country | US
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Telephone | 817-953-3064
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Fax | 817-953-3093
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. CORNELIUS HUDSON
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Credential | D MIN
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Telephone | 817-953-3064
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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 |
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License Number State |
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