All American Fun Factory (Aaff)
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Desoto, TX. Organization (NPI-2).
NPI number1386977908
StatusActive
Last updated in NPPESSep 14, 2009
Details
- NPI
- 1386977908
- Entity type
- Organization (NPI-2)
- Legal business name
- All American Fun Factory (Aaff)
- Organization subpart
- No
- Enumeration date
- Sep 14, 2009
- Last updated
- Sep 14, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | – | Yes |
Other names
- Gabriel'S Gateway (Doing Business As)
Practice location
530 Rising Ridge DrDesoto, TX 75115-3860
Phone 469-865-9209
Mailing address
530 Rising Ridge DrDesoto, TX 75115-3860
Phone 469-865-9209
Authorized official
Kiesha Mazin Easterling
Program Manager
4698659209
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