Self Richard Dba
Self Richard Dba is a Physical Disabilities Residential Treatment Facility in Fort Worth, Texas. Licensed in Texas. Registered with an NPI since 2008.
- Licensed in
- TX
- In the registry since
- 2008
- Specialties on file
- 2
Practice location Address checks out
6701 Calmont Ave Apt 101Fort Worth, TX 76116-4239
Phone: (817) 304-2892
Fax: (817) 246-4764
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Private Vehicle (primary) | Taxonomy 347C00000X · Licence 09332825 (TX) |
|---|---|
| Physical Disabilities Residential Treatment Facility | Taxonomy 320700000X · Licence 09332825 (TX) |
Record details
| NPI number | 1003062472 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Richard Baker — Home Health Nurse Aide · (817) 304-8292 |
| NPI enumerated | August 17, 2008 |
| Last updated in NPPES | August 17, 2008 |
| Mailing address | 6701 Calmont Ave Apt 101, Fort Worth, TX 76116-4239 |
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