Provider Demographics
NPI:1568698785
Name:JOURNEY LEARNING CENTER
Entity Type:Organization
Organization Name:JOURNEY LEARNING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF THE BOARD
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:KATHERINE
Authorized Official - Last Name:VILLARREAL
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:817-416-9797
Mailing Address - Street 1:2100 W NORTHWEST HWY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-7808
Mailing Address - Country:US
Mailing Address - Phone:817-416-9797
Mailing Address - Fax:
Practice Address - Street 1:2100 W NORTHWEST HWY
Practice Address - Street 2:SUITE 219
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-7808
Practice Address - Country:US
Practice Address - Phone:817-251-4739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities