Provider Demographics
NPI:1649922956
Name:BASEPOINT ACADEMY LLC
Entity type:Organization
Organization Name:BASEPOINT ACADEMY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO BPHM
Authorized Official - Prefix:
Authorized Official - First Name:BLAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:SERPA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-793-0636
Mailing Address - Street 1:711 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-9130
Mailing Address - Country:US
Mailing Address - Phone:972-325-2584
Mailing Address - Fax:972-675-7868
Practice Address - Street 1:4733 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1878
Practice Address - Country:US
Practice Address - Phone:972-325-2633
Practice Address - Fax:972-675-7868
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BASEPOINT ACADEMY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health