Organization
CAGNOLATTI AND HENDERSON INC.
Active
Other names
Lifes Second Chance Treatment Center North
Organization subpart
No
Provider details
NPI number
Authorized official
LAKISHA HENDERSON (OWNER)
(469) 360-6794
Entity
Organization
Contact information
Practice address
1451 EMPIRE CENTRAL DR STE 900, DALLAS, TX 75247-4096
(469) 360-6794
Mailing address
3543 RIO GRANDE CIR, DALLAS, TX 75233-2553
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000096
TX LICENSE
TX
Enumeration date
04/21/2020
Last updated
04/21/2020
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