Organization
INTRUST COMMUNITY SERVICES
Active
Other names
ICS
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TOMMIE NELL DAVIS (DIRECTOR)
(817) 333-4038
Entity
Organization
Contact information
Practice address
1521 SUNNY GLEN ST, FORT WORTH, TX 76134-4853
(817) 333-4038
Mailing address
PO BOX 6691, FORT WORTH, TX 76115-0691
(817) 333-4038
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
TX
Other
Enumeration date
01/07/2009
Last updated
01/07/2009
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