Organization
WALNUT CREEK RESIDENTIAL SERVICES, INC.
Active
Other names
Walnut Creek
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CONNIE ROGERS LEEMAUK (ADMINISTRATOR)
(817) 477-3930
Entity
Organization
Contact information
Practice address
622 S WALNUT CREEK DR, MANSFIELD, TX 76063-2132
(817) 477-3930
(817) 477-3315
Mailing address
622 S WALNUT CREEK DR, MANSFIELD, TX 76063-2132
(817) 477-3930
(817) 477-3315
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
120445
TX
Other
Enumeration date
05/24/2007
Last updated
08/22/2020
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