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General NPI Number Information
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NPI Number | 1356759047
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Entity Type | Organization
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Legal Business Name | THE K16 READY SOCIETY
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Dates
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Enumeration Date | 07/26/2014
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Last Update Date | 09/18/2014
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Provider Practice Location Address
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Address Line | 910 COLLIER ST SUITE 227
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City | FORT WORTH
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State | TX
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Zip | 76102-3524
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Country | US
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Telephone | 817-885-7907
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Fax | 817-887-4521
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Provider Business Mailing Address
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Address Line | 910 COLLIER ST SUITE 227
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City | FORT WORTH
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State | TX
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Zip | 76102-3524
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Country | US
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Telephone | 817-885-7907
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Fax | 817-887-4521
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. VERNON E WILSON
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Credential |
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Telephone | 817-885-7907
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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 | 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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