# EDDIE'S REACHING OUT RESIDENTIAL CORPORATION

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

## Provider details

- **NPI number:** 1821597139
- **Authorized official:** MR. EDDIE J JOHNSON (PROGRAM MANAGER)
- **Authorized official phone:** (903) 646-3171

## Contact information

- **Practice address:** 338 BOND ST, LONE STAR, TX 75668-0230
- **Practice address phone:** (903) 646-3171
- **Practice address fax:** (903) 656-0512
- **Mailing address:** PO BOX 124, LONE STAR, TX 75668-0124
- **Mailing address phone:** (903) 646-3171
- **Mailing address fax:** (903) 656-0512

## Taxonomy

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

## Other

- **Enumeration date:** 02/02/2018
- **Last updated:** 02/02/2018