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Organization

CDS AT STATE CARE AGENCY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MAHNAZ SHAHBAZI (PRESIDENT/OWNER/MANAGING DIRECTOR)
(469) 955-4041
Entity
Organization

Contact information

Practice address
3201 DALLAS PKWY STE 200, FRISCO, TX 75034-9572
(469) 955-4041
(972) 335-3778
Mailing address
3201 DALLAS PKWY STE 200, FRISCO, TX 75034-9572
(469) 955-4041
(972) 335-3778

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
251E00000X
Home Health Agency
251J00000X
Nursing Care Agency
251X00000X
Supports Brokerage Agency
253Z00000X
In Home Supportive Care Agency
Primary
372600000X
Adult Companion
3747A0650X
Attendant Care Provider
374U00000X
Home Health Aide
376J00000X
Homemaker

Other

Enumeration date
10/18/2024
Last updated
01/03/2026
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