MEDICARE: BEHAVIORAL AND MEDICAL HOMECARE INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0060GT	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043203458
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEHAVIORAL AND MEDICAL HOMECARE INC

Provider Business Mailing Address
First Line	:	1914 SKILLMAN ST # 110166
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-8559
Country	:	US
Telephone Number	:	214-828-2603
Fax Number	:	214-828-4954

Provider Business Practice Location Address
First Line	:	1914 SKILLMAN ST # 110166
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-8559
Country	:	US
Telephone Number	:	214-828-2603
Fax Number	:	214-828-4954

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JEAN CHRISTENSEN
Credential	:
Telephone Number	:	214-828-2603

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	09/23/2025

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