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General NPI Number Information
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NPI Number | 1942786363
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Entity Type | Organization
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Legal Business Name | PARENTS DEFEATING AUTISM TODAY
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Dates
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Enumeration Date | 07/18/2018
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Last Update Date | 07/18/2018
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Provider Practice Location Address
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Address Line | 400 S EAGLE DR
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City | CROWLEY
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State | TX
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Zip | 76036-3321
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Country | US
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Telephone | 817-205-1445
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 516
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City | CROWLEY
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State | TX
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Zip | 76036-0516
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Country | US
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Telephone | 817-205-1445
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. LISA M BOULTINGHOUSE
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Credential |
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Telephone | 817-205-1445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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