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Organization

LIFE INTENSITY RESIDENTIAL TREATMENT CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MONICA RENEA GRAY LCSW (CEO)
(817) 618-6001
Entity
Organization

Contact information

Practice address
12800 WESTRIDGE BLVD, FRISCO, TX 75035-3301
(817) 618-6001
Mailing address
1201 FREESIA DR, LITTLE ELM, TX 75068-4658
(817) 618-6001
(469) 405-6565

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency
261Q00000X
Clinic/Center
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
273R00000X
Psychiatric Hospital Unit
310500000X
Mental Illness Intermediate Care Facility

Other

Enumeration date
07/30/2024
Last updated
06/21/2026
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