Provider Demographics
| NPI: | 1871855494 |
|---|---|
| Name: | MULTICULTURAL RECOVERY CENTER INC |
| Entity Type: | Organization |
| Organization Name: | MULTICULTURAL RECOVERY CENTER INC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | MRS |
| Authorized Official - First Name: | ANA |
| Authorized Official - Middle Name: | H |
| Authorized Official - Last Name: | SANCHEZ |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | LCDC |
| Authorized Official - Phone: | 214-609-3300 |
| Mailing Address - Street 1: | 101 N MACARTHUR BLVD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | IRVING |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 75061-7413 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 214-463-4408 |
| Mailing Address - Fax: | 972-212-7364 |
| Practice Address - Street 1: | 101 N MACARTHUR BLVD |
| Practice Address - Street 2: | |
| Practice Address - City: | IRVING |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 75061-7413 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 214-609-3300 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2012-06-11 |
| Last Update Date: | 2022-07-13 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 364SP0807X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psychiatric/Mental Health, Child & Adolescent | Group - Multi-Specialty |
| No | 251B00000X | Agencies | Case Management | Group - Multi-Specialty | |
| No | 251S00000X | Agencies | Community/Behavioral Health | Group - Multi-Specialty | |
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | |
| No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | |
| No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health | |
| No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | |
| No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder | |
| No | 364SP0809X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psychiatric/Mental Health, Adult | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| TX | 3437428 | Medicaid |
