Organization
LAD HEALTH CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA LANE (PROGRAM DIRECTOR)
(773) 332-1017
Entity
Organization
Contact information
Practice address
3222 GLENMONT RIDGE CT, FRESNO, TX 77545-8776
(773) 332-1017
Mailing address
3222 GLENMONT RIDGE CT, FRESNO, TX 77545-8776
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/26/2021
Last updated
10/26/2021
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