Organization
EARLY CHILDHOOD INTERVENTION
Active
Other names
MHMR of Tarrant County
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA MAUGHAN HAMIL R.N. (REGISTERED NURSE)
(682) 429-0556
Entity
Organization
Contact information
Practice address
5650 N RIVERSIDE DR, SUITE 150, FORT WORTH, TX 76137-2464
(682) 429-0556
(817) 569-5149
Mailing address
3840 HULEN ST, FORT WORTH, TX 76107-7277
(682) 429-0556
(817) 569-5149
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
163W00000X
TX
Other
Enumeration date
10/23/2009
Last updated
10/23/2009
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