Organization
AUTISM TREATMENT CENTER REHABILITATION AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORETTA OUTLAW-LAM (ADMINISTRATOR)
(469) 341-0103
Entity
Organization
Contact information
Practice address
10610 METRIC DR, #101, DALLAS, TX 75243-5581
(214) 221-4405
Mailing address
10610 METRIC DR, #101, DALLAS, TX 75243-5581
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
108938
TX
283X00000X
Rehabilitation Hospital
—
—
Other
Enumeration date
10/05/2016
Last updated
10/05/2016
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