| NPI | 1710759303 |
|---|---|
| Former Legal Business Name | BEACON COMMUNITY SERVICES |
| Former Legal Business Name | INNOVATIVE INTERVENTIONS, INC. |
| Entity Type | Organization |
| Authorized Contact | ANDREA LYNN RICE Clinical Director 817-739-8013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2023-10-26 |
| Last Update Date | 2023-10-26 |