Provider Demographics
NPI:1073798633
Name:DORA ALLISON
Entity Type:Organization
Organization Name:DORA ALLISON
Other - Org Name:REACHING OUT RESIDENTIAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DORA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-240-7430
Mailing Address - Street 1:11635 FM 349
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75603-7505
Mailing Address - Country:US
Mailing Address - Phone:903-240-7430
Mailing Address - Fax:903-236-8521
Practice Address - Street 1:11635 FM 349
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75603-7505
Practice Address - Country:US
Practice Address - Phone:903-240-7430
Practice Address - Fax:903-236-8521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health