Provider Demographics
NPI:1811223993
Name:CARESTAF OF DALLAS, LP
Entity Type:Organization
Organization Name:CARESTAF OF DALLAS, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:HILLIARD
Authorized Official - Last Name:TIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-630-8844
Mailing Address - Street 1:1341 W MOCKINGBIRD LN
Mailing Address - Street 2:SUITE 242W
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-6913
Mailing Address - Country:US
Mailing Address - Phone:214-630-8844
Mailing Address - Fax:214-630-5115
Practice Address - Street 1:1341 W MOCKINGBIRD LN
Practice Address - Street 2:SUITE 242W
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-6913
Practice Address - Country:US
Practice Address - Phone:214-630-8844
Practice Address - Fax:214-630-5115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6740251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6740OtherHOME AND COMMUNITY SUPPORT SERVICES AGENCY LICENSE