NPI 1669349148

Epiphany Soul

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Waco, TX

Practice location

Address: 5900 Clover Ln, Waco, TX 76710-2809
Phone: (254) 412-9073
Mailing address: PO Box 24245, Waco, TX 76702-4245

Authorised official

Name: Kim Tatum
Title: Owner/Executive Director
Phone: (254) 412-9073

Registered specialties (3)

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X

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Case Management Agency

Agencies Taxonomy 251B00000X

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Community/Behavioral Health Agency

Agencies Taxonomy 251S00000X

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Registry record

NPI: 1669349148
Entity type: Organization
NPI issued: 20 Oct 2025
Record last updated: 4 Jun 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.