Organization
BUILDING CHANGED BEHAVIOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE MURPHY (DIRECTOR)
(478) 397-8683
Entity
Organization
Contact information
Practice address
1707 HOLLY OAK WAY, FATE, TX 75087-1250
(817) 947-2697
Mailing address
1707 HOLLY OAK WAY, FATE, TX 75087-1250
(478) 397-8683
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/28/2024
Last updated
08/06/2024
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