KETURAH HEALTH LLC NPI 1679021042

NPI Information

NPI: 1679021042
Provider Name: KETURAH HEALTH, LLC

Other Name: GREAT COMMUNITY LIVING

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
1420 VALWOOD PARKWAY
170A
CARROLLTON, TX
ZIP 75006
Phone: (469) 626-8195
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KETURAH HEALTH, LLC is a mental health (including community mental health center) clinic center in Carrollton, TX. KETURAH HEALTH, LLC NPI is 1679021042. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Great Community Living.

The provider's business location address is:

1420 VALWOOD PARKWAY
170A
CARROLLTON, TX
ZIP 75006
Phone: (469) 626-8195
Fax: (469) 857-8492

The provider's authorized official is Ket Harris Davis .
The authorized official title is Nurse Pracititioner and has the following contact phone number (469) 626-8195.

The enumeration date for this NPI number is 9/14/2016 and was last updated on 3/11/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207R00000X	Internal Medicine		AP121985	TEXAS	No
2	251B00000X	Case Management				No
3	251S00000X	Community/Behavioral Health				No
4	363LF0000X	Nurse Practitioner	Family	AP121985	TEXAS	No
5	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			No
6	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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