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Organization

ALL AMERICAN FUN FACTORY (AAFF)

Active
Other names
GABRIEL'S GATEWAY
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KIESHA MAZIN EASTERLING MED (PROGRAM MANAGER)
(469) 865-9209
Entity
Organization

Contact information

Practice address
530 RISING RIDGE DR, DESOTO, TX 75115-3860
(469) 865-9209
Mailing address
530 RISING RIDGE DR, DESOTO, TX 75115-3860
(469) 865-9209

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary

Other

Enumeration date
09/14/2009
Last updated
09/14/2009
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