Organization
SHEPHERDS GATE LIFE CHANGING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHERIE BENNETT PA (CEO/PA)
(972) 522-5665
Entity
Organization
Contact information
Practice address
817 W PIONEER PKWY, SUITE 146B, GRAND PRAIRIE, TX 75051-4710
(972) 522-5665
(972) 522-5605
Mailing address
325 KINGFISHER LN, ARLINGTON, TX 76002-3391
(817) 465-6522
(817) 468-7691
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
PA01240
TX
Other
Enumeration date
04/26/2006
Last updated
06/20/2011
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