Healthcare Provider Details

I. General information

NPI: 1720249360
Provider Name (Legal Business Name): OUR BLESSED ASSURANCE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2008
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 WEYMOUTH CT
ARLINGTON TX
76013-4821
US

IV. Provider business mailing address

1915 WEYMOUTH CT
ARLINGTON TX
76013
US

V. Phone/Fax

Practice location:
  • Phone: 817-459-4818
  • Fax:
Mailing address:
  • Phone: 817-459-4818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateTX

VIII. Authorized Official

Name: MRS. JUDY ELIZABETH ABUNASSAR
Title or Position: PRESIDENT/ADMINISTRATOR
Credential:
Phone: 817-860-3881