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NPI Code Detail

MEDICARE: RICKY'S HCS PLACE, INC

MEDICARE: RICKY'S HCS PLACE, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1320900000XIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number : 1861767493
Entity Type Code : Organization
Provider Name (Legal Business Name) : RICKY'S HCS PLACE, INC
Provider Business Mailing Address
First Line : 12001 WALDEN WOOD DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76244-5571
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12001 WALDEN WOOD DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76244-5571
Country : US
Telephone Number : 817-562-2692
Fax Number :
Authorized Official
Title or Position : CEO
Name : MRS. SYBIL ZIEGLER
Credential :
Telephone Number : 817-562-2692
Provider Enumeration Date : 03/15/2012
Last Update Date : 03/19/2012

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Directions to “RICKY'S HCS PLACE, INC ” Practice Location

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