Organization
CONSULIS HEALTH GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AKOA DONAHUE (OWNER)
(817) 507-3555
Entity
Organization
Contact information
Practice address
1164 COUNTRY CLUB LN STE 100, FORT WORTH, TX 76112-2496
(817) 507-3555
Mailing address
PO BOX 155502, FORT WORTH, TX 76155-0502
(817) 507-3555
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
Other
Enumeration date
09/19/2017
Last updated
09/19/2017
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