Provider Demographics
NPI:1295502656
Name:AAA BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:AAA BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARQUESIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLISLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-646-0001
Mailing Address - Street 1:PO BOX 494986
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75049-4986
Mailing Address - Country:US
Mailing Address - Phone:214-646-0001
Mailing Address - Fax:214-646-0004
Practice Address - Street 1:3626 N HALL ST STE 610
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-5131
Practice Address - Country:US
Practice Address - Phone:214-646-0001
Practice Address - Fax:214-646-0004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty