Organization
CHRISTIAN LIFE RESIDENTIAL SERVICES
Active
Organization
CHRISTIAN LIFE RESIDENTIAL SERVICES
Active
Other names
Martha Gail Miller
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARTHA GAIL MILLER (PROGRAM DIRECTOR)
(903) 489-9977
Entity
Organization
Contact information
Practice address
226 E ROYALL BLVD, MALAKOFF, TX 75148-9110
(903) 489-9977
(903) 698-2827
Mailing address
226 E ROYALL BLVD, MALAKOFF, TX 75148-9110
(903) 489-9977
(903) 698-2827
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972702298
—
TX
Enumeration date
10/25/2012
Last updated
10/25/2012
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