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General NPI Number Information
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NPI Number | 1982127585
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Entity Type | Organization
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Legal Business Name | BCC NATIONAL, LLC
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Dates
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Enumeration Date | 07/25/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 413 RAINIER ST
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City | DESOTO
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State | TX
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Zip | 75115-5028
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Country | US
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Telephone | 301-631-4592
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Fax |
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Provider Business Mailing Address
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Address Line | 413 RAINIER ST
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City | DESOTO
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State | TX
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Zip | 75115-5028
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Country | US
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Telephone | 301-631-4592
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. LEON A. MARYLAND
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Credential |
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Telephone | 301-222-7743
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State | TX
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