Organization
NORTH DALLAS DRUG REHABILITATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL S ACEVES SR. LCDC (SPONSOR)
(972) 446-0972
Entity
Organization
Contact information
Practice address
1606 S I 35 STE 101, CARROLLTON, TX 75006-7478
(972) 446-0972
Mailing address
1606 S I 35 STE 101, CARROLLTON, TX 75006-7478
(972) 446-0972
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
TX10127M
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TX10127M
SAMHSA/TEXAS DEPT. OF STATE HEALTH SERVICES
TX
Enumeration date
04/28/2011
Last updated
03/07/2023
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