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General NPI Number Information
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NPI Number | 1932373016
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Entity Type | Organization
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Legal Business Name | GRIMES HEALTHCARE, INC.
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Dates
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Enumeration Date | 04/18/2008
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Last Update Date | 04/18/2008
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Provider Practice Location Address
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Address Line | 1510 N HAMPTON RD SUITE 250
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City | DESOTO
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State | TX
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Zip | 75115-8300
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Country | US
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Telephone | 214-502-6942
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Fax | 214-351-2884
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Provider Business Mailing Address
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Address Line | 1510 N HAMPTON RD SUITE 250
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City | DESOTO
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State | TX
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Zip | 75115-8300
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Country | US
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Telephone | 214-502-6942
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Fax | 214-351-2884
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Authorized Official
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Title or Position | OWNER
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Name | MS. JAN C GRIMES
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Credential | LPC, RN
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Telephone | 214-502-6942
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 12493
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License Number State | TX
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