Organization
AZARIAN MANOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACE HAMRICK (ASSISTANT DIRECTOR)
(817) 597-8891
Entity
Organization
Contact information
Practice address
10325 PLEASANT MOUND DR, FORT WORTH, TX 76108-4927
(817) 597-8891
Mailing address
10325 PLEASANT MOUND DR, FORT WORTH, TX 76108-4927
(817) 597-8891
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/08/2019
Last updated
02/08/2019
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