Eddie Ellis Junior HCS

Primary specialty

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

Legal business name

EDDIE ELLIS JUNIOR HCS

Practice address

420 Tierney Rd
Fort Worth, TX 76112-6324

Phone

(817) 534-5480

Fax

(817) 534-4748

NPI assigned

Jan 8, 2009

Organization subpart

No

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

Authorized official

Name

Eddie EllisNPI 1841400132

Title

Ceo

Phone

(817) 534-5480

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 Ellis

  • Adult Development & Aging Psychologist
  • Fort Worth, TX
  • NPI 1841400132
  Authorized official Same address or phone

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231372800000",
    "number": "1932346210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 TIERNEY RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761126324",
            "telephone_number": "817-534-5480",
            "fax_number": "817-534-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 TIERNEY RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761126324",
            "telephone_number": "817-534-5480",
            "fax_number": "817-534-4748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDDIE ELLIS JUNIOR HCS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-08",
        "last_updated": "2009-01-08",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-534-5480"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald Robert Eckersley, DDS
• Olivia J Eckert
• Nancy Sue Eckhardt-Anderson, LPC
• Ecsc II, PA
• Eddie Ellis HCS Inc
• Katelyn Eddleman, LPC
• Scott A Edegbe, FNP-C
• Eden Rejuvenation Center for Wellbeing PLLC
• Kimberly T Eden, MD
• Donna Edeza Pipes, PT

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Fort Worth, TX
• Providers in Fort Worth, 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 Jan 8, 2009; 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.