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Organization

JENNY'S RESIDENT GROUP CARE #3

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JENNIFER ELLIS (OWNER)
(214) 376-0309
Entity
Organization

Contact information

Practice address
808 W RED BIRD LN, DALLAS, TX 75232-3120
(214) 376-0309
Mailing address
7306 HARDWOOD TRL, DALLAS, TX 75249-1222
(214) 376-0309

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
119225
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
119225
RESIDENTIAL GROUP CARE
TX
Enumeration date
05/21/2007
Last updated
09/01/2009
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