Provider Demographics
NPI:1508140963
Name:LINDA VERNELL HARRIS
Entity Type:Organization
Organization Name:LINDA VERNELL HARRIS
Other - Org Name:SPOTLIGHT COMMUNITY CONNECTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:VERNELL
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-939-9800
Mailing Address - Street 1:224 BARBEE DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-4403
Mailing Address - Country:US
Mailing Address - Phone:903-939-9800
Mailing Address - Fax:903-939-9800
Practice Address - Street 1:224 BARBEE DR
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-4403
Practice Address - Country:US
Practice Address - Phone:903-939-9800
Practice Address - Fax:903-939-9800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health