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General NPI Number Information
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NPI Number | 1033434790
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Entity Type | Organization
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Legal Business Name | 1ST QUALITY HCS & TXHML INC
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Dates
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Enumeration Date | 04/06/2010
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Last Update Date | 04/10/2010
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Provider Practice Location Address
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Address Line | 7908 MODESTO DR
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City | ARLINGTON
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State | TX
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Zip | 76001-6102
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Country | US
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Telephone | 817-501-5459
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Fax |
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Provider Business Mailing Address
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Address Line | 7908 MODESTO DR
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City | ARLINGTON
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State | TX
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Zip | 76001-6102
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Country | US
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Telephone | 817-501-5459
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Fax |
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Authorized Official
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Title or Position | LNFA
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Name | MR. SAM AIGUOS OMOROGBE SR.
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Credential |
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Telephone | 817-501-5459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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