Organization
ORIGINS COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA LISA DE LIMA (DIRECTOR OF COMPLIANCE)
(561) 201-8209
Entity
Organization
Contact information
Practice address
12870 HILLCREST RD STE H226, DALLAS, TX 75230-1531
(214) 817-4964
(210) 634-3961
Mailing address
4001 MAPLE AVE STE 300, DALLAS, TX 75219-3241
(214) 817-4964
(210) 634-3961
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/18/2019
Last updated
10/30/2023
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