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General NPI Number Information
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NPI Number | 1770675605
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Entity Type | Organization
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Legal Business Name | ROCK HOUSE SUPPORT SERVICES, INC.
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2252 LINGLEVILLE RD.
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City | STEPHENVILLE
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State | TX
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Zip | 76401
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Country | US
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Telephone | 254-968-4004
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Fax | 254-965-8653
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Provider Business Mailing Address
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Address Line | P.O. BOX 953
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City | STEPHENVILLE
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State | TX
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Zip | 76401
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Country | US
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Telephone | 254-968-4004
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Fax | 254-965-8653
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Authorized Official
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Title or Position | CEO
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Name | MR. LEONARD DOUGLAS SVIEN
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Credential |
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Telephone | 254-968-4004
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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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