# ANDRE HANCOCK SR. FAMILY GROUP HOME

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

## Provider details

- **NPI number:** 1396061685
- **Authorized official:** IRMA CROSBY (PRESIDENT)
- **Authorized official phone:** (214) 460-6930

## Contact information

- **Practice address:** 1012 FARM MARKET ROAD 2377, RED OAK, TX 75154
- **Practice address phone:** (214) 460-6930
- **Mailing address:** 1012 FARM MARKET ROAD 2377, RED OAK, TX 75154

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 04/13/2010
- **Last updated:** 04/13/2010