Organization
A DIVERSE FAMILY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAI GILLARD (CEO)
(210) 379-9899
Entity
Organization
Contact information
Practice address
1412 MAIN ST STE 2500, DALLAS, TX 75202-4803
(210) 379-9899
Mailing address
6788 LAKEFRONT DR, GRAND PRAIRIE, TX 75054-6831
(210) 379-9899
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
04/16/2020
Last updated
09/13/2023
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