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General NPI Number Information
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NPI Number | 1801107248
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Entity Type | Organization
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Legal Business Name | EXTRA CARE CMHC INC
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 06/30/2010
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Provider Practice Location Address
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Address Line | 3222 RUFFIN GREEN CT
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City | FRESNO
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State | TX
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Zip | 77545-8772
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Country | US
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Telephone | 713-747-5033
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Fax | 281-438-0539
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Provider Business Mailing Address
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Address Line | 3222 RUFFIN GREEN CT
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City | FRESNO
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State | TX
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Zip | 77545-8772
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Country | US
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Telephone | 713-747-5033
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Fax | 281-438-0539
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Authorized Official
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Title or Position | OWNER
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Name | RONALD TURNER
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Credential |
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Telephone | 832-630-3740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | F6227
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License Number State | TX
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