OrganizationActive
Epiphany Soul
NPI 1669349148 · Emotionally Disturbed Childrens' Residential Treatment Facility · Waco, TX
Provider details
- NPI number
- 1669349148
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Kim Tatum, Owner/Executive Director(254) 412-9073
Specialties & taxonomies
Residential Treatment Facilities
- Community/Behavioral Health Agency251S00000X
Agencies
- Case Management Agency251B00000X
Agencies
Practice location
5900 Clover Ln
Waco, TX 76710-2809
Phone: (254) 412-9073
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 24245
Waco, TX 76702-4245
Registry dates
- Enumerated
- 2025-10-20
- Last updated
- 2026-06-04
- Certified
- 2026-06-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.