Organization
AZLEWAY INC.
Active
Other names
AZLEWAY BOYS RANCH
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN BOOKER (CFO)
(903) 566-8444
Entity
Organization
Contact information
Practice address
15892 COUNTY ROAD 26, TYLER, TX 75707-2728
(903) 566-8444
(903) 566-7696
Mailing address
15892 COUNTY ROAD 26, TYLER, TX 75707-2728
(903) 566-8444
(903) 566-7696
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
622680-01
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108347901
—
TX
05
—
108347902
—
TX
Enumeration date
09/24/2007
Last updated
10/09/2007
Update your record
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