Organization · Type 2 NPI

Eddie Ellis Junior HCS

Intellectual and/or Developmental Disabilities Residential Treatment Facility · Fort Worth, TX

NPI number 1932346210 Active

Practice location

420 Tierney Rd
Fort Worth, TX 76112-6324

Call (817) 534-5480 Map

Fax (817) 534-4748

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary 320600000XNone listed

Intellectual and/or Developmental Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

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About NPI 1932346210

Eddie Ellis Junior HCS's National Provider Identifier is 1932346210, issued on Jan 8, 2009. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Residential Treatment Facility (320600000X), and the practice location is in Fort Worth, TX. The record was last updated on Jan 8, 2009.