Healthcare Provider Details

I. General information

NPI: 1861907875
Provider Name (Legal Business Name): BLESSINGS RANCH OF CENTRAL TEXAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2017
Last Update Date: 01/04/2021
Certification Date: 01/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 N GRAY ST
KILLEEN TX
76541-5245
US

IV. Provider business mailing address

PO BOX 360
KILLEEN TX
76540-0360
US

V. Phone/Fax

Practice location:
  • Phone: 419-618-1135
  • Fax:
Mailing address:
  • Phone: 419-618-1135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: CHERYL DURGIN
Title or Position: OWNER
Credential: BCBA
Phone: 254-317-5603