Organization
EDDIE'S REACHING OUT RESIDENTIAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDDIE J JOHNSON (PROGRAM MANAGER)
(903) 646-3171
Entity
Organization
Contact information
Practice address
338 BOND ST, LONE STAR, TX 75668-0230
(903) 646-3171
(903) 656-0512
Mailing address
PO BOX 124, LONE STAR, TX 75668-0124
(903) 646-3171
(903) 656-0512
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/02/2018
Last updated
02/02/2018
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