Provider Demographics
NPI:1851360861
Name:DOMINION CARE MANAGEMENT GROUP, LLC
Entity Type:Organization
Organization Name:DOMINION CARE MANAGEMENT GROUP, LLC
Other - Org Name:ELARA CARING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COMPLIANCE AND PRIVACY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MONASTIERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-768-4373
Mailing Address - Street 1:3010 LYNDON B JOHNSON FWY STE 1100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-2712
Mailing Address - Country:US
Mailing Address - Phone:517-768-4373
Mailing Address - Fax:903-537-8420
Practice Address - Street 1:7550 W IH 10 STE 720
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5816
Practice Address - Country:US
Practice Address - Phone:210-342-9922
Practice Address - Fax:210-807-6556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007948251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1651028Medicaid
TX679275Medicare Oscar/Certification