Organization
EAST TEXAS COMMUNITY SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC.
Active
Other names
Woodlea Community Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. D MICHAEL JOHNSON (PRESIDENT)
(409) 385-2626
Entity
Organization
Contact information
Practice address
101 OGLESBEE RD, SILSBEE, TX 77656-5925
(409) 385-5807
(409) 385-9304
Mailing address
PO BOX 2185, SILSBEE, TX 77656-2185
(409) 385-2626
(409) 385-9304
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
7413
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7413
VENDOR
TX
Enumeration date
02/20/2007
Last updated
08/22/2020
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