Provider Demographics
NPI:1992264402
Name:CITADEL BEHAVIORAL HEALTH SERVICES INC
Entity type:Organization
Organization Name:CITADEL BEHAVIORAL HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ADEJUMOKE
Authorized Official - Middle Name:DORCAS
Authorized Official - Last Name:ONADEKO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:469-835-7543
Mailing Address - Street 1:3802 CITADEL DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-1081
Mailing Address - Country:US
Mailing Address - Phone:469-835-7543
Mailing Address - Fax:
Practice Address - Street 1:1301 NORTHWEST HWY STE 206
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-5896
Practice Address - Country:US
Practice Address - Phone:469-434-1145
Practice Address - Fax:463-533-1769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty