Organization
OUR INSPIRATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE H PRICE (EXECUTIVE DIRECTOR)
(936) 581-3024
Entity
Organization
Contact information
Practice address
105 WEST MAIN STREET, TRINITY, TX 75862-0667
(936) 581-3024
(936) 594-0491
Mailing address
PO BOX 667, TRINITY, TX 75862-0667
(936) 581-3024
(936) 594-0491
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/19/2016
Last updated
10/19/2016
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