Jack Judson, Llc in Fort Worth - Intermediate Care Facility, Intellectual Disabilities
Jack Judson, Llc - NPI 1174683874
Jack Judson, Llc is a Intermediate Care Facility, Intellectual Disabilities in Fort Worth, Texas. Jack Judson, Llc practices all healthcare services and medical treatments related to Intermediate Care Facility, Intellectual Disabilities. The NPI Number for Jack Judson, Llc is 1174683874. The last update date is 2008-06-19.
Jack Judson, Llc's current location address is 4244 River Birch Rd, Fort Worth, Texas. You can contact this provider via phone number 8178475741. The mailing address for Jack Judson, Llc is 4244 River Birch Rd, Fort Worth, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Jack Judson, Llc |
|---|---|
| Address | 4244 River Birch Rd, Fort Worth, Texas |
| Phone Number | 8178475741 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Kirkpatrick G Alicia |
| Telephone Number | 8178475741 |
NPI Number Detail
| NPI Number | 1174683874 |
|---|---|
| Provider Enumeration Date | 2006-12-11 |
| Last Updated Date | 2008-06-19 |
Provider Mailing Address Detail
| Address | 4244 River Birch Rd |
|---|---|
| City | Fort Worth |
| State | Texas (TX) |
| Post Code | 761371132 |
| Phone Number | 8178475741 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Intermediate Care Facility, Intellectual Disabilities |
|---|---|
| Taxonomy | 315P00000X |
| Licence No | 7476 |
|
Definition: An intermediate care facility providing services for individuals with intellectual disabilities. |
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Post Comment/ Review Below
What is the unique identification code assigned to Jack Judson, Llc by the Centers for Medicare & Medicaid Services?
The Jack Judson, Llc has been issued the NPI (National Provider Identifier) 1174683874. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Jack Judson, Llc's facilities are situated?
The facilities of Jack Judson, Llc are physically located at the following address: 4244 River Birch Rd, Fort Worth, TX, 761371132.
What is the Jack Judson, Llc's area of specialization and corresponding taxonomy classification?
The Jack Judson, Llc's specialty field is Intermediate Care Facility, Intellectual Disabilities, and it falls under the taxonomy code 315P00000X, which categorizes healthcare providers based on their specialties.
On what date did the Jack Judson, Llc receive the assignment of its 1174683874 from the Centers for Medicare & Medicaid Services?
The Jack Judson, Llc was issued its 1174683874 by the Centers for Medicare & Medicaid Services on 2006-12-11.
As of what date were the details pertaining to Jack Judson, Llc last refreshed?
The information related to the Jack Judson, Llc, including its address, specialty, and other relevant details, was last updated on 2008-06-19.