Provider Demographics
NPI:1346703881
Name:CTCS THERAPY
Entity Type:Organization
Organization Name:CTCS THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:INDIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:FEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-471-3133
Mailing Address - Street 1:PO BOX 2211
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-0040
Mailing Address - Country:US
Mailing Address - Phone:833-282-7378
Mailing Address - Fax:833-329-4968
Practice Address - Street 1:9555 LEBANON RD
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-6095
Practice Address - Country:US
Practice Address - Phone:833-282-7378
Practice Address - Fax:833-329-4968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)