MEDICARE: PRECISION HEALTHCARE SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1134485576
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECISION HEALTHCARE SERVICES

Provider Business Mailing Address
First Line	:	4470 SWEETGUM WAY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-7416
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4470 SWEETGUM WAY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-7416
Country	:	US
Telephone Number	:	817-655-2542
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR/CEO
Name	:	MISS THADNESIA RILES
Credential	:
Telephone Number	:	817-655-2542

Provider Enumeration Date	:	04/10/2012
Last Update Date	:	04/10/2012

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Directions to “PRECISION HEALTHCARE SERVICES ” Practice Location

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