Provider Demographics
NPI:1518405307
Name:ENVISION HOPE
Entity Type:Organization
Organization Name:ENVISION HOPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:CASCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:9972-835-1810
Mailing Address - Street 1:5151 BELT LINE RD
Mailing Address - Street 2:SUITE 575
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-7507
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5151 BELT LINE RD
Practice Address - Street 2:SUITE 575
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-7507
Practice Address - Country:US
Practice Address - Phone:972-331-5382
Practice Address - Fax:972-331-5387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-01
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder