Organization
CHANGING LIVES BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY BANKS (MEMBER)
(832) 562-8255
Entity
Organization
Contact information
Practice address
505 E TRAVIS ST STE 208, MARSHALL, TX 75670-4281
(832) 562-8255
Mailing address
505 E TRAVIS ST STE 208, MARSHALL, TX 75670-4281
(318) 730-0191
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/08/2017
Last updated
05/26/2020
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