Organization
SAGE SUBSTANCE ABUSE GUIDANCE AND EDUCATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DANA L HOLLINGSWORTH LCDC (EXECUTIVE DIRECTOR)
(817) 238-9911
Entity
Organization
Contact information
Practice address
8401 JACKSBORO HWY, LAKESIDE, TX 76135-4351
(817) 238-9911
(817) 237-5711
Mailing address
8401 JACKSBORO HWY, LAKESIDE, TX 76135-4351
(817) 238-9911
(817) 237-5711
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
3099
TX
Other
Enumeration date
07/20/2011
Last updated
07/20/2011
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