Organization
THE SPECIAL NEEDS ACTIVITY CENTER
Active
Other names
The Special Needs Activity Center
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC L FULLER (EXECUTIVE DIRECTOR)
(469) 216-5269
Entity
Organization
Contact information
Practice address
3911 S LANCASTER RD STE 100, DALLAS, TX 75216-5682
(469) 216-5269
Mailing address
3911 S LANCASTER RD STE 100, DALLAS, TX 75216-5682
(469) 216-5269
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
305S00000X
Point of Service
—
—
347E00000X
Transportation Broker
—
—
Other
Enumeration date
02/04/2020
Last updated
02/04/2020
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