Organization
WATERFORD ACADEMY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK PETTY (OWNER)
(972) 365-5318
Entity
Organization
Contact information
Practice address
1033 LONG PRAIRIE RD STE 3, FLOWER MOUND, TX 75022-4230
(972) 355-9083
Mailing address
1033 LONG PRAIRIE RD STE 3, FLOWER MOUND, TX 75022-4230
(972) 355-9083
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/17/2014
Last updated
04/17/2014
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