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General NPI Number Information
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NPI Number | 1982997540
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Entity Type | Organization
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Legal Business Name | GRATITUDE HOUSE
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Dates
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Enumeration Date | 05/16/2011
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Last Update Date | 05/16/2011
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Provider Practice Location Address
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Address Line | 8585 N STEMMONS FWY STE 418S
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City | DALLAS
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State | TX
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Zip | 75247-3836
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Country | US
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Telephone | 214-451-7130
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Fax |
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Provider Business Mailing Address
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Address Line | 8585 N STEMMONS FWY STE 418S
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City | DALLAS
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State | TX
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Zip | 75247-3836
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Country | US
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Telephone | 214-451-7130
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DEREK ATKINS
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Credential | LPC
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Telephone | 214-451-7130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State | TX
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