Epiphany Soul

NPI #1669349148 in Waco, Texas

Provider Information

NPI Number
1669349148
Entity Type
Organization
Organization Name
Epiphany Soul
Primary Specialty
Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date
Oct 20, 2025
Last Updated
Nov 11, 2025

Practice Location

Address
5900 CLOVER LN
City
Waco
State
Texas
ZIP Code
76710-2809
Phone
(254) 412-9073

Authorized Official

Name
KIM TATUM, LCCA
Title
OWNER/EXECUTIVE DIRECTOR
Phone
(254) 412-9073

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Adolescent and Children Mental HealthAdolescent and Children Mental Health
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Residential Treatment Facility, Emotionally Disturbed Children

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