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EDDIE'S REACHING OUT RESIDENTIAL CORPORATION NPI 1821597139


NPI Information

NPI: 1821597139
Provider Name: EDDIE'S REACHING OUT RESIDENTIAL CORPORATION
Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address:
338 BOND ST
LONE STAR, TX
ZIP 75668
Phone: (903) 646-3171
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EDDIE'S REACHING OUT RESIDENTIAL CORPORATION is a residential treatment facility, intellectual and/or developmental disabilities in Lone Star, TX. The provider is 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. EDDIE'S REACHING OUT RESIDENTIAL CORPORATION NPI is 1821597139. The provider is registered as an organization entity type.

The provider's business location address is:

338 BOND ST
LONE STAR, TX
ZIP 75668-230
Phone: (903) 646-3171
Fax: (903) 656-0512

The provider's authorized official is Eddie J Johnson .
The authorized official title is Program Manager and has the following contact phone number (903) 646-3171.

The enumeration date for this NPI number is 2/2/2018 and was last updated on 2/2/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320600000XResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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