Heathers Old Skool Village

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

HEATHERS OLD SKOOL VILLAGE

Practice address

6018 Graham St
Lake Worth, TX 76135-3304

Phone

(817) 236-8275

Fax

(817) 236-8275

NPI assigned

Jul 27, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Margaret Grace Johnson

Title

Office Manager

Phone

(817) 236-8275

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1532649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532649600000",
    "number": "1497232805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6018 GRAHAM ST",
            "city": "LAKE WORTH",
            "state": "TX",
            "postal_code": "761353304",
            "telephone_number": "817-236-8275",
            "fax_number": "817-236-8275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6018 GRAHAM ST",
            "city": "LAKE WORTH",
            "state": "TX",
            "postal_code": "761353304",
            "telephone_number": "817-236-8275",
            "fax_number": "817-236-8275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEATHERS OLD SKOOL VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-27",
        "last_updated": "2018-07-27",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_middle_name": "GRACE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "817-236-8275",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naima Garrett, MD
• Katherine Leigh Garza, PHARMD
• Austin Tanner Graham, BCBA
• Green Oaks Physical Therapy Limited Partnership
• Thomas Haltom, RPH
• Joe Hinojosa, RN
• Home Town Dental of Lake Worth PC
• Home Town Dental,PA
• Kaye Hrubes, B.S. PHARMACY
• Amy Jean Hyde, PHARM D.

• Developmentally Disabled Services Day Training Agency in Lake Worth, TX
• Providers in Lake Worth, 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 Jul 27, 2018; 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.