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NPI Code Detail

MEDICARE: BEHAVIORAL HEALTH LINK CORPORATION

MEDICARE: BEHAVIORAL HEALTH LINK CORPORATION
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
11041C0700XClinical Social Worker05142TX

Other Identifiers

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

General Provider Information

NPI Number : 1801066261
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEHAVIORAL HEALTH LINK CORPORATION
Provider Business Mailing Address
First Line : 5470 GLEN LAKES DR
Second Line : SUITE 400
City : DALLAS
State : TX
Zip : 75231-4320
Country : US
Telephone Number : 214-361-9336
Fax Number :
Provider Business Practice Location Address
First Line : 5470 GLEN LAKES DR
Second Line : SUITE 400
City : DALLAS
State : TX
Zip : 75231-4320
Country : US
Telephone Number : 214-361-9336
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : ROGER POLAN
Credential : LCSW
Telephone Number : 214-361-9336
Provider Enumeration Date : 03/01/2008
Last Update Date : 08/13/2012

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Directions to “BEHAVIORAL HEALTH LINK CORPORATION ” Practice Location

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