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General NPI Number Information
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NPI Number | 1801146253
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Entity Type | Organization
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Legal Business Name | THE GREATER WORKS NETWORK
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Dates
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Enumeration Date | 09/13/2012
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Last Update Date | 01/17/2023
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Provider Practice Location Address
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Address Line | 2116 LANGSTON ST
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City | FORT WORTH
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State | TX
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Zip | 76105-3623
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Country | US
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Telephone | 817-247-3645
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 51406
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City | FORT WORTH
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State | TX
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Zip | 76105-8406
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Country | US
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Telephone | 817-247-3645
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Fax |
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Authorized Official
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Title or Position | PROGRAM ADMINISTRATOR
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Name | SHENDA BENFORD
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Credential |
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Telephone | 817-247-3645
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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 | TX
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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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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 016799
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License Number State | TX
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