Healthcare Provider Details

I. General information

NPI: 1407940059
Provider Name (Legal Business Name): WILLAND, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 S WHITE OAK RD
WHITE OAK TX
75693-1429
US

IV. Provider business mailing address

907 S WHITE OAK RD
WHITE OAK TX
75693-1429
US

V. Phone/Fax

Practice location:
  • Phone: 903-295-8114
  • Fax: 903-295-0001
Mailing address:
  • Phone: 903-295-8114
  • Fax: 903-295-0001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. SARAH D. WILBORN
Title or Position: PROGRAM MANAGER CEO
Credential:
Phone: 903-295-8114