Organization
BENTHAMBENTERPRISES, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK E BENTHAM PH.D. (PRESIDENT)
(817) 219-4500
Entity
Organization
Contact information
Practice address
4710 ESPLANADE CT, GRANBURY, TX 76049-4010
(817) 219-4599
(817) 219-4599
Mailing address
4710 ESPLANADE CT, GRANBURY, TX 76049-4010
(817) 219-4599
(817) 964-3380
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
36233
TX
Other
Enumeration date
06/27/2017
Last updated
06/27/2017
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