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Organization
FULL LIFE OUTREACH MEDICAL CENTER LLC
Active
Organization
FULL LIFE OUTREACH MEDICAL CENTER LLC
Active
Other names
Full Life Outreach Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. REGINALD BENJAMIN (PRESIDENT)
(214) 791-2863
Entity
Organization
Contact information
Practice address
4545 S BUCKNER BLVD, DALLAS, TX 75227-4207
(214) 791-2863
Mailing address
4545 S BUCKNER BLVD, DALLAS, TX 75227-4207
(214) 791-2863
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
801062647
TX
Other
Enumeration date
08/24/2009
Last updated
12/15/2025
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