Organization
ELITE 360 HEALTH AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELL NICOLE LUCAS MT (OWNER)
(214) 587-8655
Entity
Organization
Contact information
Practice address
8911 DARTWAY DR, DALLAS, TX 75227-7216
(214) 587-8655
(214) 242-9696
Mailing address
8911 DARTWAY DR, DALLAS, TX 75227-7216
(214) 587-8655
(214) 242-9696
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
01/10/2019
Last updated
12/15/2022
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