Cindy Johnson Kendrasha Gray

NPI #1720590870 in Longview, Texas

Provider Information

NPI Number: 1720590870
Entity Type: Organization
Organization Name: Cindy Johnson Kendrasha Gray
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Oct 30, 2017
Last Updated: Sep 25, 2019

Practice Location

Address: 801 S MOBBERLY AVE
City: Longview
State: Texas
ZIP Code: 75602-2037
Phone: (903) 424-8343

Authorized Official

Name: CINDY ROLLINS
Title: GENERAL PARTNER
Phone: (903) 424-8343

Specialties & Taxonomy Codes

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

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