Provider Demographics
NPI:1760259832
Name:ASL BEHAVIORAL HEALTH CLINIC PLLC
Entity Type:Organization
Organization Name:ASL BEHAVIORAL HEALTH CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EUCHARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ONWUBUYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-717-2143
Mailing Address - Street 1:103 HERRINGTON DR # TX76063
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-7615
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:103 HERRINGTON DR # TX76063
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-7615
Practice Address - Country:US
Practice Address - Phone:661-717-2143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)