Provider Demographics
NPI:1417147000
Name:LANGUAGE REASOURCE CENTER
Entity Type:Organization
Organization Name:LANGUAGE REASOURCE CENTER
Other - Org Name:BROOKWOOD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMIN/ASSISTANT QMRP
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:DEANNE
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-481-5368
Mailing Address - Street 1:2695 LONESOME DOVE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-3223
Mailing Address - Country:US
Mailing Address - Phone:817-481-5368
Mailing Address - Fax:817-251-0318
Practice Address - Street 1:2900 BROOKWOOD LN
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-5547
Practice Address - Country:US
Practice Address - Phone:817-481-5368
Practice Address - Fax:817-251-0318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000727602315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities