Lucille's Palace, LLC

NPI #1851924203 in Mansfield, Texas

Provider Information

NPI Number: 1851924203
Entity Type: Organization
Organization Name: Lucille's Palace, LLC
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Feb 13, 2020
Last Updated: Jun 5, 2023

Practice Location

Address: 3361 HARMON RD UNIT 2110
City: Mansfield
State: Texas
ZIP Code: 76063-5764
Phone: (817) 403-8465

Authorized Official

Name: MS. DARA JAMES
Title: ADMINISTRATOR
Phone: (817) 403-8465

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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