MEDICARE: DALLAS COUNTY MENTAL HEALTH & MENTAL RETARDATION CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	2084P0804X	Child & Adolescent Psychiatry Physician
2	251B00000X	Case Management Agency
3	385H00000X	Respite Care
4	2084F0202X	Forensic Psychiatry Physician
5	103K00000X	Behavior Analyst
6	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
7	261QM0850X	Adult Mental Health Clinic/Center
8	3104A0630X	Assisted Living Facility (Behavioral Disturbances)
9	171M00000X	Case Manager/Care Coordinator
10	261QM0855X	Adolescent and Children Mental Health Clinic/Center
11	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
12	261QP2300X	Primary Care Clinic/Center
13	261QD1600X	Developmental Disabilities Clinic/Center
14	251C00000X	Developmentally Disabled Services Day Training Agency
15	2084P0800X	Psychiatry Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023239886
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALLAS COUNTY MENTAL HEALTH & MENTAL RETARDATION CENTER

Provider Business Mailing Address
First Line	:	1345 RIVER BEND DR STE 200
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75247-6945
Country	:	US
Telephone Number	:	214-743-1200
Fax Number	:	214-689-6482

Provider Business Practice Location Address
First Line	:	3242 REMOND DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75211
Country	:	US
Telephone Number	:	214-743-1200
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	KELLI LAOS
Credential	:
Telephone Number	:	214-743-1200

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	02/17/2026

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