Organization
MERIT FAMILY SERVICES
Active
Other names
Merit Chemical Dependency Program, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL JONES BLACKMON (EXECUTIVE DIRECTOR)
(817) 413-9463
Entity
Organization
Contact information
Practice address
3807 E LANCASTER AVE, FORT WORTH, TX 76103-3522
(817) 413-9463
(817) 471-1227
Mailing address
3807 E LANCASTER AVE, FORT WORTH, TX 76103-3522
(817) 413-9463
(817) 427-1227
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2320-A
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163175601
—
TX
Enumeration date
05/11/2007
Last updated
11/19/2013
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