Provider Demographics
NPI:1952965899
Name:DANGLORIC COMMUNITY HEALTH SERVICES
Entity Type:Organization
Organization Name:DANGLORIC COMMUNITY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:TOBI
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:AZIRENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-590-2243
Mailing Address - Street 1:29822 BELLOUS RIVER LN
Mailing Address - Street 2:
Mailing Address - City:BROOKSHIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77423-4526
Mailing Address - Country:US
Mailing Address - Phone:617-590-2243
Mailing Address - Fax:
Practice Address - Street 1:29822 BELLOUS RIVER LN
Practice Address - Street 2:
Practice Address - City:BROOKSHIRE
Practice Address - State:TX
Practice Address - Zip Code:77423-4526
Practice Address - Country:US
Practice Address - Phone:617-590-2243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-25
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health