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Organization

K-NATION GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALEXIS MASTON PHD (CEO)
(512) 574-8840
Entity
Organization

Contact information

Practice address
9535 FOREST LN STE 124, DALLAS, TX 75243-5910
(512) 574-8840
Mailing address
801 SMOTHERMON FARM RD, LITTLE ELM, TX 75068-1009
(512) 574-8840

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
171W00000X
Contractor
172V00000X
Community Health Worker
174H00000X
Health Educator
175T00000X
Peer Specialist
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency

Other

Enumeration date
05/22/2023
Last updated
09/05/2023
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