Provider Demographics
NPI:1457490666
Name:BEHAVIORAL HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGEDORN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:580-471-6665
Mailing Address - Street 1:3809 MANCHESTER CIR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-5914
Mailing Address - Country:US
Mailing Address - Phone:580-471-6665
Mailing Address - Fax:910-795-1676
Practice Address - Street 1:3809 MANCHESTER CIR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-5914
Practice Address - Country:US
Practice Address - Phone:580-471-6665
Practice Address - Fax:910-795-1676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32594103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty