Provider Demographics
NPI:1033379755
Name:SHELTON SCHOOL AND EVALUATION CENTER
Entity Type:Organization
Organization Name:SHELTON SCHOOL AND EVALUATION CENTER
Other - Org Name:SHELTON EVALUATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, SHELTON EVALUATION CENTER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:GARNER
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:972-774-1772
Mailing Address - Street 1:15720 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-4161
Mailing Address - Country:US
Mailing Address - Phone:972-774-1772
Mailing Address - Fax:972-720-8217
Practice Address - Street 1:15720 HILLCREST RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-4161
Practice Address - Country:US
Practice Address - Phone:972-774-1772
Practice Address - Fax:972-720-8217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14136261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health