Organization
IDEA YOUTH SUCCESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DETITRIA WOODARD (OWNER)
(214) 515-2079
Entity
Organization
Contact information
Practice address
1518 VAUGHN BLVD, FORT WORTH, TX 76105-2307
(214) 515-2079
Mailing address
608 CHAPEL PL, CEDAR HILL, TX 75104-1760
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
06/05/2015
Last updated
06/05/2015
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