Provider Demographics
NPI:1962895839
Name:MABEL THOMAS
Entity type:Organization
Organization Name:MABEL THOMAS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-945-6338
Mailing Address - Street 1:PO BOX 174133
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76003-4133
Mailing Address - Country:US
Mailing Address - Phone:817-945-6338
Mailing Address - Fax:817-479-9806
Practice Address - Street 1:5401 WOODWAY DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76133-2035
Practice Address - Country:US
Practice Address - Phone:817-479-9800
Practice Address - Fax:817-479-9806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services