Provider Demographics
NPI:1568009900
Name:DYNAMIX ADULT DAY CARE SERVICES, LLC.
Entity Type:Organization
Organization Name:DYNAMIX ADULT DAY CARE SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MABERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-468-8070
Mailing Address - Street 1:101 W RENNER RD STE 280
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-2091
Mailing Address - Country:US
Mailing Address - Phone:888-462-4003
Mailing Address - Fax:888-462-4003
Practice Address - Street 1:101 W RENNER RD STE 280
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-2091
Practice Address - Country:US
Practice Address - Phone:888-462-4003
Practice Address - Fax:888-462-4003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-04
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care