Provider Demographics
NPI:1609021880
Name:WESTLEY-DAVIS, CHRISTIAN OJORE ACADEMY
Entity Type:Organization
Organization Name:WESTLEY-DAVIS, CHRISTIAN OJORE ACADEMY
Other - Org Name:WESTLEY-DAVIS ACADEMY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:LYDAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-665-3832
Mailing Address - Street 1:3306 W WALNUT ST
Mailing Address - Street 2:SUITE 410
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-7143
Mailing Address - Country:US
Mailing Address - Phone:972-665-3832
Mailing Address - Fax:972-665-3831
Practice Address - Street 1:3306 W WALNUT ST
Practice Address - Street 2:SUITE 410
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-7143
Practice Address - Country:US
Practice Address - Phone:972-665-3832
Practice Address - Fax:972-665-3831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX170287001251B00000X, 251S00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider Agency