Provider Demographics
NPI:1508554635
Name:HOPE CENTER 4 AUTISM FORT WORTH
Entity Type:Organization
Organization Name:HOPE CENTER 4 AUTISM FORT WORTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-560-1139
Mailing Address - Street 1:2751 GREEN OAKS RD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-1706
Mailing Address - Country:US
Mailing Address - Phone:817-560-1139
Mailing Address - Fax:817-560-7039
Practice Address - Street 1:4003 CALL FIELD RD
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-2633
Practice Address - Country:US
Practice Address - Phone:817-402-0330
Practice Address - Fax:817-560-7039
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOPE CENTER 4 AUTISM FORT WORTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty