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Mr. Issac Dawon Earls I
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Austin, Texas
NPI 1003019464

Issac Dawon Earls I is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Austin, TX. Issac Dawon Earls I practices in Austin, TX. The NPI Number for Issac Dawon Earls I is 1003019464 and holds a License No. (Texas).

The current practice location address for Issac Dawon Earls I is 4502 Magin Meadow Dr, Austin, TX and can be reached out via phone at 512-947-7875.

Location: 4502 Magin Meadow Dr, Austin, TX, 78744-5248
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Provider Profile Details
NPI Number
1003019464
Provider Name
Issac Dawon Earls I
Credential
Provider Entity Type
Individual
Gender
Male
Address
4502 Magin Meadow Dr, Austin, TX, 78744-5248
Phone Number
512-947-7875
Fax Number
Provider Enumeration Date
06/06/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
EARL1278 05 TX
institution
Provider Business Practice Location Address Details
Address
4502 Magin Meadow Dr
City
State
Zip
78744-5248
Phone Number
512-947-7875
Fax Number
person
Provider Business Mailing Address Details
Address
4502 Magin Meadow Dr
City
State
Zip
78744-5248
Phone Number
512-947-7875
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
License No.
(Texas)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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