NPIMap

Organization Active NPI

Life Intensity Residential Treatment Center

  • Psychiatric Residential Treatment Facility
  • Frisco, TX
National Provider Identifier
1558190405
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
Legal business name
LIFE INTENSITY RESIDENTIAL TREATMENT CENTER
Practice address
12800 Westridge Blvd
Frisco, TX 75035-3301
Phone
(817) 618-6001
NPI assigned
Jul 30, 2024
Last updated
Aug 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Authorized official

Name
Ms. Monica Renea Gray, LCSWNPI 1720362718
Title
Ceo
Phone
(817) 618-6001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X Primary

Addresses

Primary practice location

12800 Westridge Blvd
Frisco, TX 75035-3301

Mailing address

1201 Freesia Dr
Little Elm, TX 75068-4658
Phone (817) 618-6001

Other practice location 1

9300 John Hickman Pkwy Ste 801
Frisco, TX 75035-5913
Phone (817) 618-6001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210312001022 TX Part B Supplier - Clinic/Group Practice 5294141453 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Frisco, TX; Houston, TX; Lubbock, TX; Austin, TX

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Life Intensity CNSL SVCS4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12800 Westridge Blvd
Frisco, TX 75035

14300 Cornerstone Village Dr
Ste 523A
Houston, TX 77014

1103 Alexis Ct
#107
Mansfield, TX 76063

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": "1722297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786320000000",
    "number": "1558190405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 FREESIA DR",
            "city": "LITTLE ELM",
            "state": "TX",
            "postal_code": "750684658",
            "telephone_number": "817-618-6001",
            "fax_number": "469-405-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 WESTRIDGE BLVD",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750353301",
            "telephone_number": "817-618-6001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9300 John Hickman Pkwy Ste 801",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "TX",
            "postal_code": "750355913",
            "country_code": "US",
            "telephone_number": "817-618-6001",
            "fax_number": "469-405-6565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFE INTENSITY RESIDENTIAL TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-30",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "MONICA",
        "authorized_official_middle_name": "RENEA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-618-6001",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.