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General NPI Number Information
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NPI Number | 1174922975
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Entity Type | Organization
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Legal Business Name | THE WILLIS GROUP- MOVING FORWARD
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Dates
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Enumeration Date | 08/18/2014
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Last Update Date | 08/18/2014
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Provider Practice Location Address
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Address Line | 4100 SPRING VALLEY RD 612
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City | FARMERS BRANCH
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State | TX
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Zip | 75244-3629
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Country | US
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Telephone | 214-927-6179
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Fax |
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Provider Business Mailing Address
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Address Line | 609 S GOLIAD ST STE. 612
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City | ROCKWALL
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State | TX
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Zip | 75087-4003
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER WILLIS
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Credential |
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Telephone | 214-927-6179
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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