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General NPI Number Information
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NPI Number | 1124124375
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Entity Type | Organization
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Legal Business Name | HOMEWARD BOUND, INC.
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 01/07/2011
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Provider Practice Location Address
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Address Line | 233 WEST 10TH STREET
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City | DALLAS
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State | TX
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Zip | 75208
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Country | US
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Telephone | 214-941-3500
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Fax | 214-941-3422
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Provider Business Mailing Address
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Address Line | PO BOX 222194
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City | DALLAS
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State | TX
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Zip | 75222-2194
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Country | US
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Telephone | 214-941-3500
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Fax | 214-442-0080
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. DOUGLAS DENTON
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Credential |
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Telephone | 214-941-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 501B
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 501F
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License Number State | TX
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