Provider Demographics
NPI:1336417427
Name:RED BIRD EDUCATION PROGRAMS
Entity Type:Organization
Organization Name:RED BIRD EDUCATION PROGRAMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:CONAL
Authorized Official - Last Name:O'NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:LCDC
Authorized Official - Phone:214-475-3712
Mailing Address - Street 1:4549 S WESTMORELAND RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-1015
Mailing Address - Country:US
Mailing Address - Phone:214-287-3501
Mailing Address - Fax:214-623-0322
Practice Address - Street 1:4549 S WESTMORELAND RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-1015
Practice Address - Country:US
Practice Address - Phone:214-287-3501
Practice Address - Fax:214-623-0322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-05
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8925101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty