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General NPI Number Information
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NPI Number | 1962604538
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Entity Type | Organization
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Legal Business Name | OUR SEASON FAMILY SERVICES, INC.
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 12/10/2008
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Provider Practice Location Address
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Address Line | 5414 VINERIDGE PL
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City | GARLAND
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State | TX
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Zip | 75044-4640
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Country | US
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Telephone | 214-703-8047
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Fax | 972-404-8440
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Provider Business Mailing Address
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Address Line | PO BOX 801352
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City | DALLAS
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State | TX
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Zip | 75380-1352
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Country | US
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Telephone | 214-703-8047
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Fax | 972-404-8440
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. F. EUGENE MAYO
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Credential |
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Telephone | 214-703-8047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 125262
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License Number State | TX
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