Provider Demographics
NPI:1962152405
Name:ORIGINS SPI, LLC
Entity type:Organization
Organization Name:ORIGINS SPI, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRETOR
Authorized Official - Prefix:
Authorized Official - First Name:HILARY
Authorized Official - Middle Name:HOLLINGSWORTH
Authorized Official - Last Name:SOJOURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-721-2372
Mailing Address - Street 1:11777 LEBANON RD
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-6295
Mailing Address - Country:US
Mailing Address - Phone:469-827-0000
Mailing Address - Fax:
Practice Address - Street 1:11777 LEBANON RD
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-6295
Practice Address - Country:US
Practice Address - Phone:561-841-1142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-27
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility