An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
taxonomy 261QM0850X
Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family...
taxonomy 261QM0855X
Identifiers
Type
Value
Notes
01 (TX)
202461000
MAGELLAN
01 (TX)
5803588
AETNA
01 (TX)
HH5094
BLUE CROSS BLUE SHIELD
05 (TX)
1581430-01
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
Professional Addiction Specialty Services
Type code 3recorded 2006-05-27
Practice context
Multi-provider organization.
14 individual providers on file at this primary address.
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