Provider Demographics
NPI:1255650446
Name:DANA RACINSKAS, LLC
Entity Type:Organization
Organization Name:DANA RACINSKAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:RACINSKAS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:469-583-3262
Mailing Address - Street 1:224 MOCKINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-3431
Mailing Address - Country:US
Mailing Address - Phone:469-583-3262
Mailing Address - Fax:877-515-3262
Practice Address - Street 1:2021 SHOAF DR
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-2553
Practice Address - Country:US
Practice Address - Phone:469-583-3262
Practice Address - Fax:877-515-3262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX578227311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility