Provider Demographics
NPI:1750011359
Name:BASEPOINT ACADEMY, LLC
Entity Type:Organization
Organization Name:BASEPOINT ACADEMY, LLC
Other - Org Name:BASEPOINT ACADEMY- ARLINGTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO BPHM
Authorized Official - Prefix:
Authorized Official - First Name:BLAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:SERPA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-325-2584
Mailing Address - Street 1:711 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-9130
Mailing Address - Country:US
Mailing Address - Phone:972-325-2633
Mailing Address - Fax:
Practice Address - Street 1:3900 ARLINGTON HIGHLANDS BLVD STE 237
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-6040
Practice Address - Country:US
Practice Address - Phone:972-325-2633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BASEPOINT ACADEMY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health