Provider Demographics
NPI:1801210505
Name:LONE STAR DAY PROGRAM
Entity Type:Organization
Organization Name:LONE STAR DAY PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:430-235-2089
Mailing Address - Street 1:PO BOX 1168
Mailing Address - Street 2:
Mailing Address - City:LINDALE
Mailing Address - State:TX
Mailing Address - Zip Code:75771
Mailing Address - Country:US
Mailing Address - Phone:430-235-2089
Mailing Address - Fax:430-235-2087
Practice Address - Street 1:14864 COUNTY ROAD 433
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75706
Practice Address - Country:US
Practice Address - Phone:430-235-2089
Practice Address - Fax:430-235-2087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-17
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental DisabilitiesGroup - Multi-Specialty