Ability-Residential Living Assistance

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · White Oak, TX

NPI 1992055024 · NPPES record last updated Sep 17, 2012

Key facts

NPI
1992055024
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Legal business name
ABILITY-RESIDENTIAL LIVING ASSISTANCE
Practice address
1112 Acapulco LN
White Oak, TX 75693-3046
Phone
(903) 237-9988
Fax
(903) 291-0123
NPI assigned
Sep 17, 2012
Organization subpart
No

Authorized official

Name
Brandi N Boyd
Title
Director
Phone
(903) 237-9988

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Yes

Addresses

Primary practice location

1112 Acapulco LN
White Oak, TX 75693-3046

Mailing address

PO Box 7905
Longview, TX 75607-7905
Phone (903) 237-9988

Other identifiers

IdentifierTypeStateIssuer
CDSAMedicaidTX
HCSSAMedicaidTX

Other providers in White Oak, TX

All providers in White Oak, TX · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Texas

Sources for this page

Verify at the official NPI Registry.