EDDIE ELLIS JUNIOR HCS (NPI# 1932346210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1932346210 |
Entity Type | Organization |
Organization Name | EDDIE ELLIS JUNIOR HCS |
Practice Address |
420 Tierney Rd Fort Worth TX 76112-6324 |
Practice Telephone | 8175345480 |
Practice Fax Number | 8175344748 |
Mailing Telephone | 8175345480 |
Mailing Fax Number | 8175344748 |
Enumeration Date | 2009-01-08 |
Last Update Date | 2009-01-08 |
Authorized Official Name | EDDIE ELLIS (CEO) |
Authorized Official Telephone | 8175345480 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
Street Address |
420 TIERNEY RD |
City | FORT WORTH |
State | TX |
Zip Code | 76112-6324 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841400132 | Eddie Ellis | Counselor | 420 Tierney Rd, Fort Worth, TX 76112-6324 | 2007-05-23 |
1316184690 | Blessed Beginings | Clinic/Center | 420 Tierney Rd, Fort Worth, TX 76112-6324 | 2009-01-08 |
1902043276 | Beautiful Beginnings | Assisted Living Facility | 420 Tierney Rd, Fort Worth, TX 76112-6324 | 2009-01-08 |
1639316912 | Beverly Diane Ellis | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 420 Tierney Rd, Fort Worth, TX 76112-6324 | 2009-01-08 |
1376754366 | Doris Gail Benjamin | Counselor | 420 Tierney Rd, Fort Worth, TX 76112-6324 | 2007-05-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396211397 | Shelia Minor | Home Health Aide | 5648 Victoria Place, Fort Worth, TX 76112 | 2018-10-17 |
1457833816 | Joanne Medford | Physical Therapy Assistant | 1704 Wilson Rd, Fort Worth, TX 76112 | 2018-09-02 |
1821525502 | Kids & Hugs Home Therapy | Home Health | 2317 Maryel Dr., Fort Worth, TX 76112 | 2017-05-12 |
1932516846 | Neuroassessment Services LLC | Clinical Neuropsychologist | 5601 Bridge Street, Suite 500, Ft. Worth, TX 76112 | 2014-07-14 |
1114346335 | Blessed Beginnings | Day Training, Developmentally Disabled Services | 2320 Blue Smoke Court North, Fort Worth, TX 76112 | 2014-04-15 |
1790035517 | Transitions for Success Inc | In Home Supportive Care | 6228 Warrington Pl Ace, Fort Worth, TX 76112 | 2012-09-19 |
1194048116 | Jerlene Bonner Tippett | Home Health Aide | 1701 Bunch Dr, Ft Worth, TX 76112 | 2010-03-04 |
1396076543 | Roy Kenji Yamada | Emergency Medicine | 5800 Forest Bend Pl., Ft. Worth, TX 76112 | 2010-01-27 |
1437488228 | Rose A Miller | Case Manager/Care Coordinator | 7312 Laurie Drive, Ft. Worth, TX 76112 | 2009-12-08 |
1174760508 | Advocate Angels | Case Management | 6829 Gary Lane, Fort Worth, TX 76112 | 2009-01-07 |
Find all providers in zip 76112 |
Taxonomy Code | 320600000X |
Grouping | Residential Treatment Facilities |
Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306487426 | Fort Healthcare LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5833 Oakbend Trail, #200, Fort Worth, TX 76132-3900 | 2019-09-30 |
1639421894 | Mary Jean Webb | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3516 Canyon Ridge Ave, Fort Worth, TX 76103-3010 | 2012-10-11 |
1023317187 | Care King LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1129 Fairweather Dr, Fort Worth, TX 76120-3325 | 2011-03-15 |
1639316912 | Beverly Diane Ellis | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 420 Tierney Rd, Fort Worth, TX 76112-6324 | 2009-01-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619581782 | Joyful Psalm | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1354 Ravenwood Ct, Crowley, TX 76036-3472 | 2020-09-04 |
1790394161 | Modern Vintage Residential Care, LLC. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4015 Alexis Tate Cir, Missouri City, TX 77459-5039 | 2020-07-30 |
1285253856 | 1 Care Premier Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 340 N Sam Houston Pkwy E Ste A247, Houston, TX 77060-3305 | 2020-04-13 |
1568093888 | James Micah Howard | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 11911 Lakewood Trl, Tomball, TX 77377-8563 | 2020-01-27 |
1518507110 | Gems Residence LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5810 Liverpool St, Aubrey, TX 76227-1909 | 2020-01-10 |
1366081812 | Abundant Care Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1100 Maxfield St, Waco, TX 76705-2967 | 2020-01-02 |
1144877481 | Boniswa Portia Maduna | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 8000 Cook Rd Apt 1109, Houston, TX 77072-3939 | 2019-08-21 |
1871148171 | Kenneth Allen | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 135 E Menefee St, Lufkin, TX 75901-4701 | 2019-08-05 |
1124673553 | 1st A & M Healthcare Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 504 Spicewood Dr, Desoto, TX 75115-1485 | 2019-08-02 |
1558922823 | Primeway Consulting LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2712 Ferdinand, Grand Prairie, TX 75054-5519 | 2019-06-26 |
Find all providers with the same taxonomy |
City | FORT WORTH |
Zip Code | 76112 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.