Provider Demographics
NPI:1669927117
Name:KIDS GRACE CHILD PLACING AGENCY
Entity type:Organization
Organization Name:KIDS GRACE CHILD PLACING AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-222-1200
Mailing Address - Street 1:1420 WINDMILL HILL LN
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-4129
Mailing Address - Country:US
Mailing Address - Phone:459-222-1200
Mailing Address - Fax:214-432-1700
Practice Address - Street 1:1420 WINDMILL HILL LN
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-4129
Practice Address - Country:US
Practice Address - Phone:459-222-1200
Practice Address - Fax:214-432-1700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1621122-11431253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency