Dallas Detox Center

LBN: Dallas Detox Center
Dallas Detox Center is an health care organization with primary practice located at 100 Mariah Dr , Weatherford TX 76087-7408. The organization recently has only one registered license in Residential Treatment Facilities / Substance Abuse Rehabilitation Facility, which is considered as the primary health care specialty. Dallas Detox Center can be contacted via phone (888) 979-9503, or through Petrillo, Nicholas Adam via phone (978) 788-4460.

Contact Information

Primary practice address
100 Mariah Dr Weatherford TX 76087-7408
Phone: (888) 979-9503
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Petrillo, Nicholas Adam
Phone: (978) 788-4460

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X

Profile Details

NPI number 1689392987
LBN Legal business name Dallas Detox Center
DBA Doing business as
Authorized official Petrillo, Nicholas Adam
Entity Organization
Organization subpart 1 No
Enumeration date Aug 22nd, 2022
Last updated Aug 22nd, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689392987 NPPES
Texas Other 4814-4815 PRIVATE FUNDING

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