Organization
EMERGENT COMMUNITY DEVELOPMENT CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROLYN MCCULLOUGH LMSW (CEO)
(214) 432-8296
Entity
Organization
Contact information
Practice address
1140 EMPIRE CENTRAL DR, SUITE 260, DALLAS, TX 75247-4322
(214) 432-8296
(214) 203-0803
Mailing address
1140 EMPIRE CENTRAL DR, SUITE 260, DALLAS, TX 75247-4322
(214) 432-8296
(214) 203-0803
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
12479
TX
251B00000X
Case Management Agency
15397
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
311514901
—
TX
05
—
311515601
—
TX
Enumeration date
03/14/2017
Last updated
03/14/2017
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