Provider Demographics
NPI:1043823768
Name:MARK DEAN LOVING PLACE HCS
Entity Type:Organization
Organization Name:MARK DEAN LOVING PLACE HCS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WINSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-434-5166
Mailing Address - Street 1:238 FORDHAM DR
Mailing Address - Street 2:
Mailing Address - City:GLENN HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:75154-7908
Mailing Address - Country:US
Mailing Address - Phone:469-285-8795
Mailing Address - Fax:
Practice Address - Street 1:238 FORDHAM DR
Practice Address - Street 2:
Practice Address - City:GLENN HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:75154-7908
Practice Address - Country:US
Practice Address - Phone:469-285-8795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-24
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health