Individual
MR. KEORRIC LAMONT HOLIDAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3705 FORT HUNT DRIVE, ARLINGTON, TX 76016
(817) 919-7013
(682) 587-4118
Mailing address
3705 FORT HUNT DRIVE, ARLINGTON, TX 76016
(817) 919-7013
(682) 587-4118
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
14557506
TX
Other
Enumeration date
12/26/2008
Last updated
12/26/2008
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