Provider Demographics
NPI:1922282946
Name:C3 ACADEMY, LLC
Entity Type:Organization
Organization Name:C3 ACADEMY, LLC
Other - Org Name:88 CENTS GALORE STORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATO
Authorized Official - Prefix:MS
Authorized Official - First Name:TRISHA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:972-623-2322
Mailing Address - Street 1:P.O. BOX 499
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75106
Mailing Address - Country:US
Mailing Address - Phone:972-623-2322
Mailing Address - Fax:972-602-6793
Practice Address - Street 1:2005 108TH STREET
Practice Address - Street 2:STE. 503
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050
Practice Address - Country:US
Practice Address - Phone:972-623-2322
Practice Address - Fax:972-602-6793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility