Organization
360 BEHAVIORAL HEALTH OF TEXAS LLC
Active
Parent organization
CA PC MIDCO, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CA PC MIDCO, INC
Authorized official
MR. DENNIS KOGOD (EXECUTIVE CHAIRMAN/CEO)
(949) 285-8969
Entity
Organization
Contact information
Practice address
120 E SOUTH TOWN DR, TYLER, TX 75703-4747
(903) 630-7077
Mailing address
16946 SHERMAN WAY, VAN NUYS, CA 91406-3613
(949) 339-0401
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/04/2019
Last updated
02/04/2019
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