Provider Demographics
NPI:1013312131
Name:DIFFERENT IS BEAUTIFUL LLC
Entity Type:Organization
Organization Name:DIFFERENT IS BEAUTIFUL LLC
Other - Org Name:DIFFERENT IS BEAUTIFUL LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEATHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-506-4426
Mailing Address - Street 1:PO BOX 196152
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-8622
Mailing Address - Country:US
Mailing Address - Phone:311-506-4426
Mailing Address - Fax:
Practice Address - Street 1:545 VIA AMALFI APT 312
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-2863
Practice Address - Country:US
Practice Address - Phone:317-506-4426
Practice Address - Fax:972-695-4894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-31
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX472216890Medicaid