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TRANSFORMATION WACO

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SARAH PEDROTTI (EXECUTIVE DIRECTOR STUDENT ADVOCACY)
(254) 754-9169
Entity
Organization

Contact information

Practice address
3005 EDNA AVE, WACO, TX 76708-1849
(254) 754-9169
Mailing address
3005 EDNA AVE, WACO, TX 76708-1849
(254) 754-9169

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
152W00000X
Optometrist
152WP0200X
Pediatric Optometrist
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency
261Q00000X
Clinic/Center
Primary
261QM0855X
Adolescent and Children Mental Health Clinic/Center
343900000X
Non-emergency Medical Transport (VAN)

Other

Enumeration date
10/26/2023
Last updated
10/26/2023
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