# IDEA YOUTH SUCCESS CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013397892
- **Authorized official:** MRS. DETITRIA WOODARD (OWNER)
- **Authorized official phone:** (214) 515-2079

## Contact information

- **Practice address:** 1518 VAUGHN BLVD, FORT WORTH, TX 76105-2307
- **Practice address phone:** (214) 515-2079
- **Mailing address:** 608 CHAPEL PL, CEDAR HILL, TX 75104-1760

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |
| 3245S0500X | Children's Substance Abuse Rehabilitation Facility | — | — | — |

## Other

- **Enumeration date:** 06/05/2015
- **Last updated:** 06/05/2015