OrganizationActive
A Vision of Choice
NPI 1417623232 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Fort Worth, TX
Provider details
- NPI number
- 1417623232
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Callie Mitchell, Owner(817) 849-4005
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
4705 Palm Ridge Dr
Fort Worth, TX 76133-8316
Phone: (817) 849-4005
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 331231
Fort Worth, TX 76163-1231
Registry dates
- Enumerated
- 2021-08-20
- Last updated
- 2023-03-29
- Certified
- 2023-03-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.