Gallus Detox Dallas

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

GALLUS DETOX DALLAS

Practice address

1776 US-287
Ste 250
Mansfield, TX 76063

Phone

(928) 533-0872

NPI assigned

Sep 24, 2021

Organization subpart

No

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

Authorized official

Name

Georgina Carroll, RN

Title

Director of Clinical Operations

Phone

(928) 533-0872

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1632441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672704000000",
    "number": "1073284402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S JACKSON ST STE 220",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802093134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 US-287",
            "address_2": "STE 250",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "76063",
            "telephone_number": "928-533-0872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALLUS DETOX DALLAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-24",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "GEORGINA",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL OPERATIONS",
        "authorized_official_telephone_number": "928-533-0872",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda J Gaccetta, DO
• Laurence A. Gadbois Jr., FNP-C
• Galactical Commercial LLC
• Doyle Fairchild Gallman Jr., D.O.
• Jeffrey S Gallup, LPC
• Amanda Rene Gambrell, PTA
• Kehila Karolina Gamez, MSN, APRN, FNP-C
• Phillip Gandy
• Navneet Garcha, MD
• Celeste Garcia

• Substance Abuse Rehabilitation Facility in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Substance Abuse Rehabilitation Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.