Provider Demographics
NPI:1336412840
Name:MULTICULTURAL CENTER
Entity Type:Organization
Organization Name:MULTICULTURAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:POECK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:214-609-3300
Mailing Address - Street 1:5026 ROSS AVE
Mailing Address - Street 2:STE 3
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-7707
Mailing Address - Country:US
Mailing Address - Phone:214-609-3300
Mailing Address - Fax:325-574-1333
Practice Address - Street 1:5026 ROSS AVE
Practice Address - Street 2:STE 3
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-7707
Practice Address - Country:US
Practice Address - Phone:214-609-3300
Practice Address - Fax:325-574-1333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-14
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16128261QM0850X, 261QM0855X, 261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health