Provider Demographics
NPI:1376960609
Name:CONFLICT MANAGEMENT INSTITUTE, PLLC
Entity Type:Organization
Organization Name:CONFLICT MANAGEMENT INSTITUTE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GROVES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:940-453-7594
Mailing Address - Street 1:3505 YUCCA DR
Mailing Address - Street 2:STE 109
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2704
Mailing Address - Country:US
Mailing Address - Phone:940-453-7594
Mailing Address - Fax:
Practice Address - Street 1:3505 YUCCA DR
Practice Address - Street 2:STE 109
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2704
Practice Address - Country:US
Practice Address - Phone:940-453-7594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-25
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health