Organization
A HOUSE OF REFUGE, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CAGER EATON HAYNES (EXECUTIVE DIRECTOR)
(402) 714-1857
Entity
Organization
Contact information
Practice address
1151 MONTERREY TRL, MESQUITE, TX 75149-5277
(402) 714-1857
Mailing address
PO BOX 2653, MCKINNEY, TX 75070-8174
(402) 714-1857
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/23/2022
Last updated
06/20/2024
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