Provider Demographics
NPI:1639299274
Name:BERRY FAMILY SERVICES
Entity type:Organization
Organization Name:BERRY FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-412-4707
Mailing Address - Street 1:5700 ROWLETT RD
Mailing Address - Street 2:STE 110
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-7922
Mailing Address - Country:US
Mailing Address - Phone:972-412-4707
Mailing Address - Fax:972-202-0314
Practice Address - Street 1:5700 ROWLETT RD
Practice Address - Street 2:STE 110
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75089-7922
Practice Address - Country:US
Practice Address - Phone:972-412-4707
Practice Address - Fax:972-202-0314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1639299274OtherCARE
TX1639299274Medicaid