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General NPI Number Information
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NPI Number | 1710279377
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Entity Type | Organization
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Legal Business Name | CHURCHILL EVALUATION CENTERS
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Dates
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Enumeration Date | 05/13/2011
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Last Update Date | 05/13/2011
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Provider Practice Location Address
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Address Line | 2225 E RANDOL MILL RD STE 101
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City | ARLINGTON
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State | TX
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Zip | 76011-6354
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Country | US
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Telephone | 817-861-4600
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Fax | 817-377-3610
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Provider Business Mailing Address
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Address Line | PO BOX 120965
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City | ARLINGTON
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State | TX
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Zip | 76012-0965
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Country | US
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Telephone | 817-861-4600
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. JANNA RUSSELL
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Credential |
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Telephone | 817-861-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | TX
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