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General NPI Number Information
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NPI Number | 1821294349
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Entity Type | Organization
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Legal Business Name | SOCIAL WORK CONNECTION
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 07/19/2007
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Provider Practice Location Address
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Address Line | 421 VILLA DR #209
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City | WACO
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State | TX
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Zip | 76710-7034
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Country | US
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Telephone | 254-405-2702
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Fax | 866-686-9651
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Provider Business Mailing Address
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Address Line | 421 VILLA DR #209
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City | WACO
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State | TX
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Zip | 76710-7034
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Country | US
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Telephone | 254-405-2702
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Fax | 866-686-9651
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. GAYLA K GRISHAM
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Credential | LBSW
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Telephone | 254-405-2702
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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 | 33966
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License Number State | TX
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