Organization
MANAGED SERVICE GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE CLARKE-SMITH (MANAGER)
(800) 516-7760
Entity
Organization
Contact information
Practice address
22 BRIERCROFT OFFICE PARK STE 3, LUBBOCK, TX 79412-3089
(800) 516-7760
Mailing address
PO BOX 3554, MCKINNEY, TX 75070-8194
(214) 536-4818
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QM3000X
Medically Fragile Infants and Children Day Care
—
—
Other
Enumeration date
10/30/2018
Last updated
12/10/2019
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