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General NPI Number Information
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NPI Number | 1558287797
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Entity Type | Organization
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Legal Business Name | WALNUT GROVE COMMUNITY SERVICES
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Dates
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Enumeration Date | 06/24/2026
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Last Update Date | 06/24/2026
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Provider Practice Location Address
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Address Line | 809 N GRAY ST
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City | KILLEEN
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State | TX
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Zip | 76541-4851
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Country | US
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Telephone | 817-902-1592
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Fax |
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Provider Business Mailing Address
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Address Line | 6805 GILBERT DR
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City | KILLEEN
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State | TX
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Zip | 76549-2334
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Country | US
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Telephone | 817-902-1592
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Fax |
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Authorized Official
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Title or Position | PROGRAM MANAGER
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Name | BRANDI RENEE BRUNER
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Credential |
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Telephone | 817-902-1593
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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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Taxonomy #2
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #4
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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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