The Polo Group LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

THE POLO GROUP LLC

Practice address

1626 W Highway 287 Business Ste 101
Waxahachie, TX 75165-4728

Phone

(972) 906-9112

Fax

(972) 906-9112

NPI assigned

Apr 15, 2020

Organization subpart

No

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

Authorized official

Name

Lilliam Polo, LCDCNPI 1134587314

Title

Ceo

Phone

(972) 906-9112

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• The Polo Group Former legal business name

Electronic endpoints 1

Locations

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.

• Lilliam Polo

  • Addiction (Substance Use Disorder) Counselor
  • Waxahachie, TX
  • NPI 1134587314
  NPD Authorized official

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

{
    "created_epoch": "1586908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586908800000",
    "number": "1083233498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 W HIGHWAY 287 BUSINESS STE 101",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751654728",
            "telephone_number": "972-906-9112",
            "fax_number": "972-906-9112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 W HIGHWAY 287 BUSINESS STE 101",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751654728",
            "telephone_number": "972-906-9112",
            "fax_number": "972-906-9112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Oak Lawn Ave Ste 107",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752194438",
            "country_code": "US",
            "telephone_number": "972-906-9112",
            "fax_number": "972-906-9112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE POLO GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-15",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A",
        "authorized_official_last_name": "POLO",
        "authorized_official_first_name": "LILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "972-906-9112",
        "authorized_official_credential": "LCDC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013287721",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thepologroup@icloud.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1626 W Highway 287 Business Ste 101",
            "city": "Waxahachie",
            "state": "TX",
            "country_code": "US",
            "postal_code": "751654728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "The Polo Group",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Waxahachie, TX
• Providers in Waxahachie, TX by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.