Organization
A DESTINY'S ROSE HCS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONI M MARTIN-MOORE (ADMINISTRATOR)
(214) 778-7228
Entity
Organization
Contact information
Practice address
6330 S LANCASTER RD, DALLAS, TX 75241-3800
(214) 778-7228
(214) 377-5009
Mailing address
PO BOX 543174, GRAND PRAIRIE, TX 75054
(214) 778-7228
(214) 377-5009
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05
—
TX
Enumeration date
02/13/2017
Last updated
12/03/2021
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