Organization
FHASES-HCS,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYVONNE GREENE-SIMINGTON (OWNER MANAGER)
(817) 975-9448
Entity
Organization
Contact information
Practice address
2429 PARKSIDE DR, GRAND PRAIRIE, TX 75052-4612
(817) 975-9448
(972) 206-2819
Mailing address
2429 PARKSIDE DR, GRAND PRAIRIE, TX 75052-4612
(817) 975-9448
(972) 206-2819
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251C00000X
—
TX
Enumeration date
05/25/2008
Last updated
05/25/2008
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