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General NPI Number Information
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NPI Number | 1285644385
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Entity Type | Organization
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Legal Business Name | J R HENDERSON & ASSOCIATES, LLC
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 01/29/2008
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Provider Practice Location Address
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Address Line | 1234 ROYAL OAK DR
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City | DESOTO
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State | TX
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Zip | 75115-3408
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Country | US
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Telephone | 214-912-5494
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Fax | 972-228-1670
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Provider Business Mailing Address
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Address Line | 1234 ROYAL OAK DR
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City | DESOTO
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State | TX
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Zip | 75115-3408
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Country | US
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Telephone | 214-912-9404
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Fax | 972-228-1670
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. JIMMIE RANCE HENDERSON
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Credential | LMSW
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Telephone | 214-912-5494
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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 | S41944
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License Number State | TX
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