Provider Demographics
NPI:1770165219
Name:DAN CARE LLC
Entity type:Organization
Organization Name:DAN CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KINYAMAHANGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:737-781-4755
Mailing Address - Street 1:5516 SPRINGFORD CIRCLE
Mailing Address - Street 2:APT. 1426
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244
Mailing Address - Country:US
Mailing Address - Phone:737-781-4755
Mailing Address - Fax:
Practice Address - Street 1:5516 SPRINGFORD CIRCLE
Practice Address - Street 2:APT. 1426
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244
Practice Address - Country:US
Practice Address - Phone:737-781-4755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-23
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities