MEDICARE: PRITCHETT FAMILY SERVICES 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
1	251S00000X	Community/Behavioral Health Agency
2	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1841539228
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRITCHETT FAMILY SERVICES INC

Provider Business Mailing Address
First Line	:	6914 MANITOBA AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75241-3443
Country	:	US
Telephone Number	:	214-375-0222
Fax Number	:	214-375-0226

Provider Business Practice Location Address
First Line	:	6914 MANITOBA AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75241-3443
Country	:	US
Telephone Number	:	214-375-0222
Fax Number	:	214-375-0226

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	MARQUITA MARSHELL DOSS
Credential	:
Telephone Number	:	214-375-0222

Provider Enumeration Date	:	02/05/2013
Last Update Date	:	02/05/2013

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Directions to “PRITCHETT FAMILY SERVICES INC ” Practice Location

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