Eddie's Reaching Out Residential Corporation

NPI #1821597139 in Lone Star, Texas

Provider Information

NPI Number: 1821597139
Entity Type: Organization
Organization Name: Eddie's Reaching Out Residential Corporation
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Feb 2, 2018
Last Updated: Feb 2, 2018

Practice Location

Address: 338 BOND ST
City: Lone Star
State: Texas
ZIP Code: 75668-0230
Phone: (903) 646-3171

Authorized Official

Name: MR. EDDIE J JOHNSON
Title: PROGRAM MANAGER
Phone: (903) 646-3171

Specialties & Taxonomy Codes

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

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