Andre Hancock Sr. Family Group Home

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

ANDRE HANCOCK SR. FAMILY GROUP HOME

Practice address

1012 Farm Market Road 2377
Red Oak, TX 75154

Phone

(214) 460-6930

NPI assigned

Apr 13, 2010

Last updated

Apr 13, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Irma Crosby

Title

President

Phone

(214) 460-6930

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1271116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271116800000",
    "number": "1396061685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 FARM MARKET ROAD 2377",
            "city": "RED OAK",
            "state": "TX",
            "postal_code": "75154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 FARM MARKET ROAD 2377",
            "city": "RED OAK",
            "state": "TX",
            "postal_code": "75154",
            "telephone_number": "214-460-6930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDRE HANCOCK SR. FAMILY GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-13",
        "last_updated": "2010-04-13",
        "status": "A",
        "authorized_official_last_name": "CROSBY",
        "authorized_official_first_name": "IRMA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-460-6930"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Red Oak, TX
• Providers in Red Oak, TX by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2010; 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.