Provider Demographics
NPI:1437175494
Name:DALLAS METROCARE SERVICES
Entity Type:Organization
Organization Name:DALLAS METROCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QMHP
Authorized Official - Prefix:MS
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:SHAVON
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:214-381-7070
Mailing Address - Street 1:1100 RIVER BEND DR APT 71
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-3707
Mailing Address - Country:US
Mailing Address - Phone:214-381-7070
Mailing Address - Fax:214-381-7071
Practice Address - Street 1:1100 RIVER BEND DR APT 71
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-3707
Practice Address - Country:US
Practice Address - Phone:214-381-7070
Practice Address - Fax:214-381-7071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children