NPIMap

Organization Active NPI

Bricolage Behavioral Health, LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Flower Mound, TX
National Provider Identifier
1053877688
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
BRICOLAGE BEHAVIORAL HEALTH, LLC
Practice address
3204 Long Prairie Rd Ste a
Flower Mound, TX 75022-2718
Phone
(469) 968-5700
NPI assigned
Feb 19, 2019
Last updated
Oct 29, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Charles Raab
Title
Chief Financial Officer
Phone
(469) 968-5700

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU

Addresses

Primary practice location

3204 Long Prairie Rd Ste a
Flower Mound, TX 75022-2718

Mailing address

3204 Long Prairie Rd Ste a
Flower Mound, TX 75022-2718
Phone (469) 968-5700

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603929600000",
    "number": "1053877688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3204 LONG PRAIRIE RD STE A",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750222718",
            "telephone_number": "469-968-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3204 LONG PRAIRIE RD STE A",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750222718",
            "telephone_number": "469-968-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRICOLAGE BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-19",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A",
        "authorized_official_last_name": "RAAB",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "469-968-5700"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flower Mound, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.