Individual provider · Type 1 NPI
Tina C. Wade
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Brenham, TX
Practice location
1303 E Alamo St
Brenham, TX 77833-3823
Mailing address
PO Box 1765
Brenham, TX 77834-1765
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | None listed |
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
About NPI 1336386192
Tina C. Wade's National Provider Identifier is 1336386192, issued on Jan 15, 2009. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Brenham, TX. The record was last updated on Jan 15, 2009.