Palace 1 Therapeutic Ranch

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

PALACE 1 THERAPEUTIC RANCH

Doing business as

Palace 1 Art Day Hab

Practice address

2115 Mesa Wood Dr
Glenn Heights, TX 75154-8583

Phone

(469) 235-5443

NPI assigned

Sep 13, 2022

Organization subpart

Yes

Parent organization

PALACE 1 ART DAY HABAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Virginia Irene Wooten-Rush

Title

Ceo/Owner

Phone

(469) 235-5443

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Palace 1 Art Day Hab Doing business as

Part of

Palace 1Art Day Hab

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663027200000",
    "number": "1033831599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2862",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751232862",
            "telephone_number": "469-235-5443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 MESA WOOD DR",
            "city": "GLENN HEIGHTS",
            "state": "TX",
            "postal_code": "751548583",
            "telephone_number": "469-235-5443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALACE 1 THERAPEUTIC RANCH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALACE 1 ART DAY HAB",
        "enumeration_date": "2022-09-13",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A",
        "authorized_official_last_name": "WOOTEN-RUSH",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_middle_name": "IRENE",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "469-235-5443",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXPAYER NUMBER",
            "identifier": "32072801361",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palace 1 Art Day Hab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dafani Norman
• Heather Laura O'Flaherty, MA, LPC
• Brittany R Odom, LVN
• Jill Kimberly Ofoh, LPC, MED
• Charity Elyssa Pace
• Palace 1Art Day Hab
• Ebony S Perry
• Haley Renee Perry
• Michelle Hill Peterson
• Quality of Life Health Care Solutions PLLC

• Developmentally Disabled Services Day Training Agency in Glenn Heights, TX
• Providers in Glenn Heights, TX by specialty
• Developmentally Disabled Services Day Training Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.