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Moses Way

Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Desoto, TX. Organization (NPI-2).

NPI number1376939413
StatusActive
Last updated in NPPESApr 14, 2015

Details

NPI
1376939413
Entity type
Organization (NPI-2)
Legal business name
Moses Way
Organization subpart
No
Enumeration date
Apr 14, 2015
Last updated
Apr 14, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities–TXYes

Practice location

1024 Trailwood Dr
Desoto, TX 75115-5544

Phone 469-964-1247 · Fax 469-297-4417

Mailing address

1024 Trailwood Dr
Desoto, TX 75115-5544

Phone 469-964-1247 · Fax 469-297-4417

Authorized official

Freddie Lee Miller
Program Director
4699641247

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