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General NPI Number Information
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NPI Number | 1366689176
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Entity Type | Organization
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Legal Business Name | DIANA SCOGGINS FOSTER CARE
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Dates
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Enumeration Date | 01/15/2009
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Last Update Date | 01/15/2009
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Provider Practice Location Address
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Address Line | 19301 FM 463
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City | DEVINE
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State | TX
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Zip | 78016-4072
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Country | US
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Telephone | 830-663-3715
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Fax | 830-663-3715
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Provider Business Mailing Address
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Address Line | 19301 FM 463
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City | DEVINE
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State | TX
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Zip | 78016-4072
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Country | US
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Telephone | 830-663-3715
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Fax | 830-663-3715
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Authorized Official
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Title or Position | ADULT FOSTER CARE
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Name | MS. DIANA LEE SCOGGINS
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Credential | NONE
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Telephone | 830-663-3715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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