Organization
HEATHERS OLD SKOOL VILLAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARGARET GRACE JOHNSON (OFFICE MANAGER)
(817) 236-8275
Entity
Organization
Contact information
Practice address
6018 GRAHAM ST, LAKE WORTH, TX 76135-3304
(817) 236-8275
(817) 236-8275
Mailing address
6018 GRAHAM ST, LAKE WORTH, TX 76135-3304
(817) 236-8275
(817) 236-8275
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
TX
Other
Enumeration date
07/27/2018
Last updated
07/27/2018
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