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General NPI Number Information
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NPI Number | 1396517207
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Entity Type | Organization
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Legal Business Name | VARIANT SUPPORT SERVICES OF TEXAS L.L.C.
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Dates
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Enumeration Date | 10/24/2023
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Last Update Date | 11/16/2023
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Provider Practice Location Address
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Address Line | 3110 GUADALUPE DR
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City | ROCKWALL
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State | TX
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Zip | 75032-4409
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Country | US
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Telephone | 434-989-5073
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Fax |
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Provider Business Mailing Address
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Address Line | 8225 FEDORA DR
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City | CHESTERFIELD
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State | VA
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Zip | 23838-6280
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Country | US
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Telephone | 434-989-5073
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. VERNITA TAYLOR
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Credential |
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Telephone | 434-989-5073
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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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