Organization
MY HEALTH MY RESOURCES OF TARRANT COUNTY
Active
Other names
MHMR of Tarrant County, Training Residence #5
Organization subpart
No
Provider details
NPI number
Authorized official
YOLANDA MONTES (ENROLLMENT COORDINATOR)
(817) 569-5235
Entity
Organization
Contact information
Practice address
4833 DIAZ AVE, FORT WORTH, TX 76107-6131
(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
—
000381201
—
TX
Enumeration date
05/21/2007
Last updated
08/18/2021
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