Provider Demographics
NPI:1013373059
Name:THE MANACLE FOUNDATION INC
Entity Type:Organization
Organization Name:THE MANACLE FOUNDATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOWNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-825-8754
Mailing Address - Street 1:3201 FRANKLIN AVE
Mailing Address - Street 2:UNIT 8
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-7365
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3201 FRANKLIN AVE
Practice Address - Street 2:UNIT 8
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-7365
Practice Address - Country:US
Practice Address - Phone:254-825-8475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No253J00000XAgenciesFoster Care Agency