Organization
VIOLA'S HAVEN HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIADA PARKS (MANGER)
(817) 706-3896
Entity
Organization
Contact information
Practice address
1832 ALANBROOKE DR, FORT WORTH, TX 76140-5150
(817) 706-3896
Mailing address
1832 ALANBROOKE DR, FORT WORTH, TX 76140-5150
(817) 706-3896
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/22/2024
Last updated
07/22/2024
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