Tracie Ellen Angelly

NPI #1194881276 in Whitt, Texas

Provider Information

NPI Number: 1194881276
Entity Type: Organization
Organization Name: Tracie Ellen Angelly
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Dec 31, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 411 BRUMBELOW RD
City: Whitt
State: Texas
ZIP Code: 76490-2306
Phone: (940) 859-1955

Authorized Official

Name: TRACIE ELLEN ANGELLY
Title: ADMINISTRATOR
Phone: (940) 859-1955

Specialties & Taxonomy Codes

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

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