Provider Demographics
NPI:1265045694
Name:DIMIDE INC.
Entity Type:Organization
Organization Name:DIMIDE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OLADIMEJI
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLAWOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-423-0251
Mailing Address - Street 1:1928 TRANSCENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:ST PAUL
Mailing Address - State:TX
Mailing Address - Zip Code:75098-0900
Mailing Address - Country:US
Mailing Address - Phone:903-423-0251
Mailing Address - Fax:
Practice Address - Street 1:1928 TRANSCENDENCE DR
Practice Address - Street 2:
Practice Address - City:ST PAUL
Practice Address - State:TX
Practice Address - Zip Code:75098-0900
Practice Address - Country:US
Practice Address - Phone:903-423-0251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty