Provider Demographics
NPI:1033303011
Name:PERFORMANCE PLUS
Entity type:Organization
Organization Name:PERFORMANCE PLUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:CEAP
Authorized Official - Phone:903-892-2866
Mailing Address - Street 1:1223 W MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-7435
Mailing Address - Country:US
Mailing Address - Phone:903-892-2866
Mailing Address - Fax:903-893-5183
Practice Address - Street 1:1223 W MULBERRY ST
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-7435
Practice Address - Country:US
Practice Address - Phone:903-892-2866
Practice Address - Fax:903-893-5183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty