Provider Demographics
NPI:1912374216
Name:NORTH TEXAS SOLUTIONS FOR RECOVERY, INC
Entity Type:Organization
Organization Name:NORTH TEXAS SOLUTIONS FOR RECOVERY, INC
Other - Org Name:SOLUTIONS OF NORTH TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:WISENBAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-898-6202
Mailing Address - Street 1:1516 N RUDDELL ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76209-3338
Mailing Address - Country:US
Mailing Address - Phone:940-898-6202
Mailing Address - Fax:940-382-5435
Practice Address - Street 1:1516 N RUDDELL ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76209-3338
Practice Address - Country:US
Practice Address - Phone:904-898-6202
Practice Address - Fax:904-382-5435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-22
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3905-3906OtherTEXAS STATE SUBSTANCE ABUSE TREATMENT FACILITY LICENSE