Provider Demographics
NPI:1548313646
Name:FIRST BAPTIST CHURCH, ARLINGTON, TX
Entity type:Organization
Organization Name:FIRST BAPTIST CHURCH, ARLINGTON, TX
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:STEDHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DMIN
Authorized Official - Phone:817-276-6412
Mailing Address - Street 1:301 S CENTER ST
Mailing Address - Street 2:SUITE 214
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-7139
Mailing Address - Country:US
Mailing Address - Phone:817-276-6412
Mailing Address - Fax:817-276-6438
Practice Address - Street 1:301 S CENTER ST
Practice Address - Street 2:SUITE 214
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-7139
Practice Address - Country:US
Practice Address - Phone:817-276-6412
Practice Address - Fax:817-276-6438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2283106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty