Provider Demographics
NPI:1144507815
Name:URSI, LLC
Entity type:Organization
Organization Name:URSI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRATICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:NONE
Authorized Official - Phone:214-905-5090
Mailing Address - Street 1:8222 DOUGLAS AVE
Mailing Address - Street 2:SUITE 375
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225
Mailing Address - Country:US
Mailing Address - Phone:214-905-5090
Mailing Address - Fax:214-905-1998
Practice Address - Street 1:8222 DOUGLAS AVE
Practice Address - Street 2:SUITE 375
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5923
Practice Address - Country:US
Practice Address - Phone:214-905-5090
Practice Address - Fax:214-905-1998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty