Provider Demographics
NPI:1194038802
Name:CARON FOUNDATION OF TEXAS, INC
Entity Type:Organization
Organization Name:CARON FOUNDATION OF TEXAS, INC
Other - Org Name:CARON TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:BECCI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-743-6451
Mailing Address - Street 1:PO BOX 150
Mailing Address - Street 2:
Mailing Address - City:WERNERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19565-0150
Mailing Address - Country:US
Mailing Address - Phone:800-648-2332
Mailing Address - Fax:
Practice Address - Street 1:3800 COUNTY ROAD
Practice Address - Street 2:444
Practice Address - City:PRINCETON
Practice Address - State:TX
Practice Address - Zip Code:75407-4432
Practice Address - Country:US
Practice Address - Phone:800-678-2332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RICHARD J. CARON FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-22
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33153316324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility