Organization
SITI AND JIDO PARK FOUNDATION, INC
Active
Other names
Life Works Community
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY LYNN PARK MD (PRESIDENT BOARD OF DIRECTORS)
(940) 222-8528
Entity
Organization
Contact information
Practice address
1804 CORNELL LN, DENTON, TX 76201-1727
(940) 222-8528
Mailing address
1804 CORNELL LN, DENTON, TX 76201-1727
(940) 222-8528
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
TX
251V00000X
Voluntary or Charitable Agency
—
TX
Other
Enumeration date
02/19/2016
Last updated
02/19/2016
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