Provider Demographics
NPI:1225379068
Name:PARENT SERVICES CENTER, INC.
Entity Type:Organization
Organization Name:PARENT SERVICES CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:WELLS
Authorized Official - Last Name:JUDD
Authorized Official - Suffix:
Authorized Official - Credentials:BA, MS
Authorized Official - Phone:903-595-2235
Mailing Address - Street 1:4411 OLD BULLARD RD STE 602
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-1215
Mailing Address - Country:US
Mailing Address - Phone:903-595-2235
Mailing Address - Fax:
Practice Address - Street 1:4411 OLD BULLARD RD STE 602
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-1215
Practice Address - Country:US
Practice Address - Phone:903-595-2235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX248044171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty