Organization
MJM INNOVATIVE LIVING OF NORTH TEXAS,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDDIE L SLAUGHTER (ADMINISTATOR)
(469) 252-0116
Entity
Organization
Contact information
Practice address
1833 SHASTA VIEW DR, JUSTIN, TX 76247-5712
(469) 252-0116
Mailing address
1833 SHASTA VIEW DR, JUSTIN, TX 76247-5712
(469) 252-0116
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/04/2006
Last updated
08/22/2020
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