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General NPI Number Information
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NPI Number | 1174967798
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Entity Type | Organization
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Legal Business Name | KIDNET FOUNDATION
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Dates
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Enumeration Date | 04/25/2013
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Last Update Date | 04/25/2013
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Provider Practice Location Address
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Address Line | 6065 DUCK CREEK DR
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City | GARLAND
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State | TX
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Zip | 75043-3649
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Country | US
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Telephone | 972-303-5303
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 140085
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City | DALLAS
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State | TX
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Zip | 75214-0085
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Country | US
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Telephone | 972-303-5303
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ALLICIA FRYE
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Credential |
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Telephone | 972-303-5303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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