Organization
MY HEALTH MY RESOURCES OF TARRANT COUNTY
Active
Other names
MHMR of Tarrant County, Cordova Place
Organization subpart
No
Provider details
NPI number
Authorized official
YOLANDA MONTES (ENROLLMENT COORDINATOR)
(817) 569-5235
Entity
Organization
Contact information
Practice address
5212 CORDOVA AVE, FORT WORTH, TX 76132-1641
(817) 569-4396
(817) 569-4517
Mailing address
PO BOX 2603, HTN CLIENT ACCOUNTING, FORT WORTH, TX 76113-2603
(817) 569-4396
(817) 569-4517
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000757601
—
TX
Enumeration date
05/09/2007
Last updated
08/18/2021
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