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General NPI Number Information
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NPI Number | 1669739249
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Entity Type | Organization
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Legal Business Name | A-TARK, INC
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Dates
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Enumeration Date | 04/19/2012
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | 12662 REDBUD VILLA LN
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City | HOUSTON
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State | TX
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Zip | 77086-3181
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Country | US
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Telephone | 832-434-1230
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Fax | 713-633-4243
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Provider Business Mailing Address
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Address Line | 12662 REDBUD VILLA LN
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City | HOUSTON
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State | TX
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Zip | 77086-3181
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Country | US
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Telephone | 832-434-1230
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Fax | 713-633-4243
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MR. DEAUNSEY ALEXANDER
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Credential |
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Telephone | 832-434-1230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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