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Organization
RELEVANT KNOWLEDGE
Active
Organization
RELEVANT KNOWLEDGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRACIE RENEE REED (DIRECTOR)
(214) 466-3365
Entity
Organization
Contact information
Practice address
6211 DENTON DRIVE, SUITE C, DALLAS, TX 75235
(214) 466-3365
Mailing address
6211 DENTON DRIVE, SUITE C, DALLAS, TX 75235
(214) 466-3365
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
—
NULL
251K00000X
Public Health or Welfare Agency
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
252Y00000X
Early Intervention Provider Agency
—
NULL
253J00000X
Foster Care Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
Other
Enumeration date
04/30/2013
Last updated
01/23/2014
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