Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Beverly Diane Ellis

Organization Intellectual and/or Developmental Disabilities Residential Treatment Facility · NPI 1639316912

Beverly Diane Ellis is an Intellectual and/or Developmental Disabilities Residential Treatment Facility in Fort Worth, Texas. Registered with an NPI since 2009.

In the registry since
2009
Specialties on file
2

Practice location Address checks out

420 Tierney Rd
Fort Worth, TX 76112-6324
Phone: (817) 534-5480
Fax: (817) 534-4748
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (primary) Taxonomy 320900000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility Taxonomy 320600000X

Record details

NPI number1639316912
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Beverly Ellis — Ceo · (817) 534-5480
NPI enumeratedJanuary 8, 2009
Last updated in NPPESJanuary 8, 2009
Mailing address420 Tierney Rd, Fort Worth, TX 76112-6324

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