Organization
PROFESSIONAL CARE FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LATONDRA DENISE ASKEW (ADMINISTRATOR)
(469) 877-8557
Entity
Organization
Contact information
Practice address
6327 TEAGUE DR, DALLAS, TX 75241-4844
(214) 372-3690
(972) 224-5589
Mailing address
6327 TEAGUE DR, DALLAS, TX 75241-4844
(214) 372-3690
(972) 224-5589
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
030258
TX
Other
Enumeration date
06/26/2007
Last updated
08/28/2007
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