Provider Demographics
NPI:1861907875
Name:BLESSINGS RANCH OF CENTRAL TEXAS
Entity type:Organization
Organization Name:BLESSINGS RANCH OF CENTRAL TEXAS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:DURGIN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:254-317-5603
Mailing Address - Street 1:PO BOX 360
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76540-0360
Mailing Address - Country:US
Mailing Address - Phone:419-618-1135
Mailing Address - Fax:
Practice Address - Street 1:316 N GRAY ST
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-5245
Practice Address - Country:US
Practice Address - Phone:419-618-1135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-13
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty