Organization
WEST TEXAS CHILD DEVELOPMENT CENTER
Active
Organization
WEST TEXAS CHILD DEVELOPMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRANT MICHAEL INGRAM M.ED, BCBA (OWENR)
(325) 320-3204
Entity
Organization
Contact information
Practice address
2032 W HARRIS AVE, SAN ANGELO, TX 76901-3806
(325) 320-3204
Mailing address
2032 W HARRIS AVE, SAN ANGELO, TX 76901-3806
(325) 320-3204
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
1-13-14897
TX
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
05/05/2014
Last updated
05/05/2014
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