Provider Demographics
NPI:1013952191
Name:THE LA SIMA FOUNDATION,INC
Entity Type:Organization
Organization Name:THE LA SIMA FOUNDATION,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:E
Authorized Official - Last Name:CLARKSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCDC
Authorized Official - Phone:214-941-1132
Mailing Address - Street 1:777 S R L THORNTON FWY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75203-2956
Mailing Address - Country:US
Mailing Address - Phone:214-941-1132
Mailing Address - Fax:214-941-1135
Practice Address - Street 1:777 S R L THORNTON FWY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-2956
Practice Address - Country:US
Practice Address - Phone:214-941-1132
Practice Address - Fax:214-941-1135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7143324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
132833OtherVALUEOPTIONS