Provider Demographics
NPI:1548449689
Name:CITIZENS DEVELOPMENT CENTER
Entity type:Organization
Organization Name:CITIZENS DEVELOPMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:HELEN
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CRC
Authorized Official - Phone:214-637-2911
Mailing Address - Street 1:8800 AMBASSADOR ROW
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-4621
Mailing Address - Country:US
Mailing Address - Phone:214-637-2911
Mailing Address - Fax:214-637-2929
Practice Address - Street 1:8800 AMBASSADOR ROW
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-4621
Practice Address - Country:US
Practice Address - Phone:214-637-2911
Practice Address - Fax:214-637-2929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120065251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services