NPIMap

Organization Active NPI

Home of Life Journey

  • Behavior Analyst
  • Ft Worth, TX
National Provider Identifier
1871852970
Registry record updated May 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
HOME OF LIFE JOURNEY
Practice address
4228 Hardeman St
Ft Worth, TX 76119-3870
Phone
(817) 769-0379
NPI assigned
May 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2012

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

Authorized official

Name
Miss Marian Denise Walters, MSW
Title
Owner/Program Manager
Phone
(817) 769-0379

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

4228 Hardeman St
Ft Worth, TX 76119-3870

Mailing address

4228 Hardeman St
Fort Worth, TX 76119-3870
Phone (817) 769-0379

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1336521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336521600000",
    "number": "1871852970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4228 HARDEMAN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761193870",
            "telephone_number": "817-769-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4228 HARDEMAN ST",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761193870",
            "telephone_number": "817-769-0379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME OF LIFE JOURNEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-09",
        "last_updated": "2012-05-09",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "MARIAN",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "OWNER/PROGRAM MANAGER",
        "authorized_official_telephone_number": "817-769-0379",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2012; 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.