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General NPI Number Information
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NPI Number | 1235534991
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Entity Type | Organization
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Legal Business Name | IMAGINE ART
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Dates
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Enumeration Date | 10/23/2014
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 1127 TILLERY STREET UNIT 68
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City | AUSTIN
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State | TX
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Zip | 78702-3032
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Country | US
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Telephone | 512-554-2406
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Fax | 512-524-4948
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Provider Business Mailing Address
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Address Line | PO BOX 29687
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City | AUSTIN
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State | TX
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Zip | 78755-6687
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Country | US
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Telephone | 512-554-2406
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Fax | 512-524-4948
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. DEBORAH ANN KIZER
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Credential |
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Telephone | 512-554-2406
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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