OrganizationActive
Epic Pediatric Therapy
NPI 1760891824 · Child Intellectual and/or Developmental Disabilities Respite Care · Beaumont, TX
Provider details
- NPI number
- 1760891824
- Entity type
- Organization
- Primary specialty
- Child Intellectual and/or Developmental Disabilities Respite CareRespite Care Facility
- Organization subpart
- No
- Authorized official
- Kimberly Gordon, Cota(786) 797-0382
- License
- 212133 (TX)
Specialties & taxonomies
- Child Intellectual and/or Developmental Disabilities Respite CarePrimary385HR2060XLicense 212133 (TX)
Respite Care Facility
Practice location
6155 Sienna Trl Apt 612
Beaumont, TX 77708-4357
Phone: (786) 797-0382
Approximate (ZIP-level) locationGet directions
Mailing address
6155 Sienna Trl Apt 612
Beaumont, TX 77708-4357
Registry dates
- Enumerated
- 2014-08-03
- Last updated
- 2014-08-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.