Provider Demographics
NPI:1356651608
Name:CHURCHILL HEALTHCARE EDUCATION RESOURCES AND OUTREACH
Entity Type:Organization
Organization Name:CHURCHILL HEALTHCARE EDUCATION RESOURCES AND OUTREACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MISS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:M
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-942-3200
Mailing Address - Street 1:400 S ZANG BLVD
Mailing Address - Street 2:STE. 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-6600
Mailing Address - Country:US
Mailing Address - Phone:214-942-3200
Mailing Address - Fax:214-942-3240
Practice Address - Street 1:400 S ZANG BLVD
Practice Address - Street 2:STE. 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-6600
Practice Address - Country:US
Practice Address - Phone:214-942-3200
Practice Address - Fax:214-942-3240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-19
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services