Provider Demographics
NPI:1164111464
Name:CARBO INVESTMENTS LLC
Entity Type:Organization
Organization Name:CARBO INVESTMENTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LEESEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-698-9371
Mailing Address - Street 1:8624 FERGUSON RD UNIT 571766
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75357-7589
Mailing Address - Country:US
Mailing Address - Phone:214-698-9371
Mailing Address - Fax:
Practice Address - Street 1:629 MEDINAH RD
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154-2750
Practice Address - Country:US
Practice Address - Phone:469-415-5345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities