GALLUS DETOX DALLAS
NPI 1073284402
Substance Abuse Rehabilitation Facility in Mansfield, TX

Active since September 24, 2021CLIA 45D2254568 · Waiver
1776 US-287, STE 250, MANSFIELD, TX 76063(928) 533-0872 Get Directions Write a Review

NPPES record last updated: January 3, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 3, 2023, Sep 30, 2021, Sep 24, 2021 (3 updates tracked since 2021).

About Gallus Detox Dallas NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GALLUS DETOX DALLAS (NPI 1073284402) is a healthcare organization registered as a substance abuse rehabilitation facility in Mansfield, Texas and active in the NPI registry since September 2021. The organization holds a CLIA Waiver certificate valid through March 3, 2028 and lists Georgina Carroll, Director Of Clinical Operations, as its authorized official.

NPPES Registry Identity

NPI1073284402
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameGALLUS DETOX DALLAS
Location Address1776 US-287, STE 250Mansfield, TX 76063
Mailing Address300 S Jackson St Ste 220Denver, CO 80209-3134
Organization SubpartNo
Authorized OfficialGeorgina CarrollDirector Of Clinical Operations · (928) 533-0872
Enumeration DateSeptember 24, 2021
Last NPPES UpdateJanuary 3, 20233 updates tracked since enumeration
NPPES CertifiedJanuary 3, 2023
NPI 1073284402 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

1776 US-287, Mansfield, TX 76063

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2254568

Gallus Detox Dallas, PLLC · Mansfield, TX
Active · expires Mar 3, 2028
CLIA Number45D2254568
Laboratory TypeInpatient Detox Clinic
Certificate Effective DateMarch 4, 2026
Certificate Expiration DateMarch 3, 2028
Laboratory DirectorJeri Lawrence
Laboratory Phone(928) 533-0872
Laboratory LocationGallus Detox Dallas, PLLC1776 Us 287 Frontage Rd Suite 250, Mansfield, TX 76063
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gallus Detox Dallas's NPI number?

The NPI number for Gallus Detox Dallas is 1073284402. It was assigned to this organization in the NPPES registry on September 24, 2021.

Where is Gallus Detox Dallas located?

Gallus Detox Dallas is located at 1776 Us-287 Ste 250, Mansfield, TX 76063. The listed phone number is (928) 533-0872.

What is Gallus Detox Dallas's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does Gallus Detox Dallas hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2254568) is associated with this NPI, valid through March 3, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Gallus Detox Dallas accept?

Health plans from Blue Cross and Blue Shield of Texas list Gallus Detox Dallas as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Gallus Detox Dallas was last updated on January 3, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.