Provider Demographics
NPI:1821476904
Name:WACO PARTNERSHIP FOR PSYCHOLOGICAL AND SPRITUAL CARE
Entity Type:Organization
Organization Name:WACO PARTNERSHIP FOR PSYCHOLOGICAL AND SPRITUAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:EADES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC, LMFT
Authorized Official - Phone:254-498-7176
Mailing Address - Street 1:PO BOX 2421
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76703-2421
Mailing Address - Country:US
Mailing Address - Phone:254-498-7176
Mailing Address - Fax:
Practice Address - Street 1:900 AUSTIN AVE
Practice Address - Street 2:SUITE 803
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76701-1902
Practice Address - Country:US
Practice Address - Phone:254-498-7176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health