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Organization

FULL LIFE OUTREACH MEDICAL CENTER LLC

Active
Other names
Full Life Outreach Center
Organization subpart
No

Provider details

NPI number
Authorized official
MR. REGINALD BENJAMIN (PRESIDENT)
(214) 791-2863
Entity
Organization

Contact information

Practice address
4545 S BUCKNER BLVD, DALLAS, TX 75227-4207
(214) 791-2863
Mailing address
4545 S BUCKNER BLVD, DALLAS, TX 75227-4207
(214) 791-2863

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
801062647
TX

Other

Enumeration date
08/24/2009
Last updated
12/15/2025
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