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Organization
CENTRAL BEHAVIORAL CLINIC LLC
Active
Organization
CENTRAL BEHAVIORAL CLINIC LLC
Active
Other names
CENTRAL BEHAVIORAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
FATIMAH THIAM (RN)
(254) 803-0408
Entity
Organization
Contact information
Practice address
2919 MARKET LOOP, TEMPLE, TX 76502-1856
(254) 803-0408
Mailing address
1226 LAKEWAY CROSSING DR, TEMPLE, TX 76502-6146
(254) 803-0408
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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