Organization
THE FOUR FIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANCE WILLIAM LUNA LCDC (FOUNDER)
(972) 806-0877
Entity
Organization
Contact information
Practice address
114 PUGH LN, CORSICANA, TX 75109-5420
(972) 806-0877
Mailing address
5954 BROADWAY BLVD # 105, GARLAND, TX 75043-5822
(972) 806-0877
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/13/2025
Last updated
05/13/2025
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