Provider Demographics
NPI:1275750127
Name:METROCARE SERVICES
Entity Type:Organization
Organization Name:METROCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QMHP
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:ENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:214-371-0474
Mailing Address - Street 1:1539 KINGSLEY DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75216-6984
Mailing Address - Country:US
Mailing Address - Phone:214-372-6361
Mailing Address - Fax:
Practice Address - Street 1:3330 S LANCASTER RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-4531
Practice Address - Country:US
Practice Address - Phone:214-371-0474
Practice Address - Fax:214-371-3933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty