IDEA YOUTH SUCCESS CENTER NPI 1013397892

NPI Information

IDEA YOUTH SUCCESS CENTER is a residential treatment facility emotionally disturbed children in Fort Worth, TX. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. IDEA YOUTH SUCCESS CENTER NPI is 1013397892. The provider is registered as an organization entity type.

The provider's business location address is:

1518 VAUGHN BLVD
FORT WORTH, TX
ZIP 76105-307
Phone: (214) 515-2079

The provider's authorized official is Detitria Woodard .
The authorized official title is Owner and has the following contact phone number (214) 515-2079.

The enumeration date for this NPI number is 6/5/2015 and was last updated on 6/5/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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