Organization
INNER CITY RECOVERY AND BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE WASHINGTON (MANAGER)
(214) 228-3072
Entity
Organization
Contact information
Practice address
4817 BRENTWOOD STAIR RD STE 105, FORT WORTH, TX 76103-1734
(214) 228-3072
Mailing address
4817 BRENTWOOD STAIR RD STE 105, FORT WORTH, TX 76103-1734
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
251B00000X
Case Management Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
10/19/2021
Last updated
11/28/2022
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