Organization
SDT VISIONTHEHOPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANNE TATUM (OWNER)
(214) 728-9902
Entity
Organization
Contact information
Practice address
1302 HENDRICK, DALLAS, TX 75216
(214) 728-9902
Mailing address
6505 ATHA DR, DALLAS, TX 75217-5612
(214) 728-9902
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
103717
TX
261QH0100X
Health Service Clinic/Center
103717
TX
302R00000X
Health Maintenance Organization
103717
TX
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
103717
TX
374U00000X
Home Health Aide
103717
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
831595538
—
TX
Enumeration date
09/24/2010
Last updated
09/24/2010
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