Eddie's Reaching Out Residential Corporation

Primary specialty

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

Legal business name

EDDIE'S REACHING OUT RESIDENTIAL CORPORATION

Practice address

338 Bond St
Lone Star, TX 75668-0230

Phone

(903) 646-3171

Fax

(903) 656-0512

NPI assigned

Feb 2, 2018

Last updated

Feb 2, 2018By 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

Mr. Eddie J JohnsonNPI 1134630957

Title

Program Manager

Phone

(903) 646-3171

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eddie Johnson

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Lone Star, TX
  • NPI 1134630957

  Residential Treatment Facility, Intellectual and/Or Developmental Disabilities

  NPD Authorized official

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

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517529600000",
    "number": "1821597139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 124",
            "city": "LONE STAR",
            "state": "TX",
            "postal_code": "756680124",
            "telephone_number": "903-646-3171",
            "fax_number": "903-656-0512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 BOND ST",
            "city": "LONE STAR",
            "state": "TX",
            "postal_code": "756680230",
            "telephone_number": "903-646-3171",
            "fax_number": "903-656-0512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDDIE'S REACHING OUT RESIDENTIAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-02",
        "last_updated": "2018-02-02",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "903-646-3171",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Aneta Corley, RN, CFNP
• Froggies Helping Hands (Froggies Reaching Out Residential Services)
• Carla Gleaton, P.T.
• Tara Gray, FNP
• Helping Hands of East Texas Home Healthcare
• Helping Hands of East Texas Homehealthcare

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Lone Star, TX
• Providers in Lone Star, 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 Feb 2, 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.