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Organization subpart
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Provider details

NPI number
Authorized official
DARCY NEKO BENFORD (DIRECTOR)
(254) 498-9361
Entity
Organization

Contact information

Practice address
112 S 35TH ST, WACO, TX 76710-7308
(254) 498-9361
(254) 235-0429
Mailing address
112 S 35TH ST, WACO, TX 76710-7308
(254) 498-9361
(254) 235-0429

Taxonomy

Speciality
Code
Description
License number
State
174200000X
Meals Provider
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
251V00000X
Voluntary or Charitable Agency
261QA0600X
Adult Day Care Clinic/Center
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
385H00000X
Respite Care
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
385HR2065X
Child Physical Disabilities Respite Care

Other

Enumeration date
09/14/2017
Last updated
03/07/2024
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