Organization
4 CORNERS RESIDENTIAL CARE, LLC
Active
Other names
4 Corners Residential Services, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
RODERIC HORTON (OWNER)
(972) 897-0548
Entity
Organization
Contact information
Practice address
3816 ACACIA TRL, THE COLONY, TX 75056-3681
(972) 897-0548
Mailing address
3816 ACACIA TRL, THE COLONY, TX 75056-3681
(972) 897-0548
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
343900000X
TRANSPORTATION SERVICES/VAN
TX
Enumeration date
01/06/2015
Last updated
05/20/2015
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