All American Fun Factory (aaff)

NPI #1386977908 in Desoto, Texas

Provider Information

NPI Number: 1386977908
Entity Type: Organization
Organization Name: All American Fun Factory (aaff)
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Sep 14, 2009
Last Updated: Sep 14, 2009

Practice Location

Address: 530 RISING RIDGE DR
City: Desoto
State: Texas
ZIP Code: 75115-3860
Phone: (469) 865-9209

Authorized Official

Name: MRS. KIESHA MAZIN EASTERLING, MED
Title: PROGRAM MANAGER
Phone: (469) 865-9209

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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