Organization
LAKEISHA BRAZIEL - DAVIS LLC
Active
Other names
Greatworks
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAKEISHA N BRAZIEL-DAVIS (OWNER/DIRECTOR)
(817) 986-8732
Entity
Organization
Contact information
Practice address
2601 PECOS ST, FORT WORTH, TX 76119-5609
(817) 535-2688
Mailing address
321 CHRISTIE AVE, EVERMAN, TX 76140-4520
(817) 986-8732
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/03/2014
Last updated
07/03/2014
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