Provider Demographics
NPI:1972050946
Name:FUTURISTIKIDZ RESIDENTIAL FACILITY
Entity Type:Organization
Organization Name:FUTURISTIKIDZ RESIDENTIAL FACILITY
Other - Org Name:NONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:STUARD
Authorized Official - Suffix:
Authorized Official - Credentials:LCDC
Authorized Official - Phone:832-888-7259
Mailing Address - Street 1:683 FM 980 RD
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77320-7406
Mailing Address - Country:US
Mailing Address - Phone:832-888-7259
Mailing Address - Fax:
Practice Address - Street 1:683 FM 980RD.
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77320
Practice Address - Country:US
Practice Address - Phone:888-832-7259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty