Organization
ANDREWS CENTER/ KCP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL FONTENOT (CFO)
(903) 597-1351
Entity
Organization
Contact information
Practice address
1710 W FRONT ST, TYLER, TX 75702-6823
(903) 593-4004
Mailing address
1710 W FRONT ST, TYLER, TX 75702-6823
(903) 593-4004
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/28/2006
Last updated
08/22/2020
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