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NPI Code Detail

MEDICARE: CHRISTIAN CARE CENTERS, INC.

MEDICARE: CHRISTIAN CARE CENTERS, INC.
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
1261QR0400XRehabilitation Clinic/Center

General Provider Information

NPI Number : 1831648278
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHRISTIAN CARE CENTERS, INC.
Provider Business Mailing Address
First Line : 5100 RANDOL MILL RD
Second Line :
City : FORT WORTH
State : TX
Zip : 76112-1553
Country : US
Telephone Number : 817-548-3258
Fax Number : 866-529-3789
Provider Business Practice Location Address
First Line : 5100 RANDOL MILL RD
Second Line :
City : FORT WORTH
State : TX
Zip : 76112-1553
Country : US
Telephone Number : 817-548-3258
Fax Number : 866-529-3789
Authorized Official
Title or Position : CIO
Name : MR. MARK SPENCER
Credential :
Telephone Number : 972-686-2430
Provider Enumeration Date : 09/27/2016
Last Update Date : 11/22/2016

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Directions to “CHRISTIAN CARE CENTERS, INC. ” Practice Location

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