# DALLAS VA MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447354980
- **Authorized official:** MR. KABAKA WAMUKUTA POKOSSA MASTERS OF SCINECE (ADDICTION THERAPIST)
- **Authorized official phone:** (214) 857-0837

## Contact information

- **Practice address:** 4500 S LANCASTER RD, DALLAS, TX 75216-7167
- **Practice address phone:** (323) 327-7618
- **Mailing address:** 4500 S LANCASTER RD, DALLAS, TX 75216-7167
- **Mailing address phone:** (323) 327-7618

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |

## Other

- **Enumeration date:** 09/12/2006
- **Last updated:** 08/22/2020