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Organization

ASTRID VILLAGE ASSISTED CENTRE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NGOZI STEPHANIE CHUKWUKELU RN (PROGRAM DIRECTOR)
(214) 766-1174
Entity
Organization

Contact information

Practice address
2860 CLEAR CREEK DR, ROCKWALL, TX 75032-9247
(214) 766-1174
Mailing address
2548 PLAZA BLVD, DALLAS, TX 75241-6439
(214) 766-1174

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
TX
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
320700000X
Physical Disabilities Residential Treatment Facility
320800000X
Mental Illness Community Based Residential Treatment Facility
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Enumeration date
02/26/2016
Last updated
02/26/2016
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