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General NPI Number Information
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NPI Number | 1972054815
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Entity Type | Organization
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Legal Business Name | TEXAS COMMUNITY LIVING INC
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Dates
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Enumeration Date | 10/15/2016
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Last Update Date | 10/15/2016
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Provider Practice Location Address
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Address Line | 2008 SHANNON DR
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City | MCKINNEY
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State | TX
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Zip | 75070-3320
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Country | US
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Telephone | 469-264-2177
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Fax |
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Provider Business Mailing Address
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Address Line | 2008 SHANNON DR
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City | MCKINNEY
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State | TX
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Zip | 75070-3320
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Country | US
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Telephone | 469-264-2177
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Fax |
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Authorized Official
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Title or Position | PROGRAM MANAGER
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Name | CHARLIE BARTHOLOMEW
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Credential |
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Telephone | 469-264-2177
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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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