Provider Demographics
NPI:1992980601
Name:SCOTT&SCOTTDEPENDABLEPLACEMENTSERVICE
Entity type:Organization
Organization Name:SCOTT&SCOTTDEPENDABLEPLACEMENTSERVICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BENNIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:512-496-6623
Mailing Address - Street 1:PO BOX 3394
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78691-3394
Mailing Address - Country:US
Mailing Address - Phone:512-496-6623
Mailing Address - Fax:512-416-6446
Practice Address - Street 1:15835 FTHL FARMS LOOP
Practice Address - Street 2:# 2313
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-3231
Practice Address - Country:US
Practice Address - Phone:512-496-6623
Practice Address - Fax:512-416-6446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities