Educare Community Living Corporation Texas

NPI #1104689603 in Ft Worth, Texas

Provider Information

NPI Number: 1104689603
Entity Type: Organization
Organization Name: Educare Community Living Corporation Texas
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Feb 6, 2024
Last Updated: Feb 6, 2024

Practice Location

Address: 1200 EVERMAN PKWY
City: Ft Worth
State: Texas
ZIP Code: 76140-5002
Phone: (817) 293-2975

Authorized Official

Name: ANGIE MATTINGLY
Title: MGR PROVIDER ENROLLMENT
Phone: (502) 394-2100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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