Organization
GREEN OAKS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE ASHWORTH PH.D. (EXECUTIVE DIRECTOR, OUTPATIENT SERV)
(972) 969-2472
Entity
Organization
Contact information
Practice address
12221 MERIT DR STE 400, DALLAS, TX 75251-2291
(972) 770-1012
Mailing address
12221 MERIT DR STE 400, DALLAS, TX 75251-2291
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
13829
TX
Other
Enumeration date
10/01/2015
Last updated
10/01/2015
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